Provider Demographics
NPI:1699002717
Name:CULPEPPER, M RENEE (RPH)
Entity type:Individual
Prefix:
First Name:M
Middle Name:RENEE
Last Name:CULPEPPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 PURPLE SAGE CT
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-5546
Mailing Address - Country:US
Mailing Address - Phone:817-249-5434
Mailing Address - Fax:817-249-6231
Practice Address - Street 1:8651 BENBROOK BLVD
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-2543
Practice Address - Country:US
Practice Address - Phone:817-249-5434
Practice Address - Fax:817-249-6231
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist