Provider Demographics
NPI:1851685242
Name:BURTON, JOLENE KENNA (PHARMD)
Entity type:Individual
Prefix:
First Name:JOLENE
Middle Name:KENNA
Last Name:BURTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:
Other - Last Name:DRAGOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8845 SIX PINES DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2675
Mailing Address - Country:US
Mailing Address - Phone:281-465-1767
Mailing Address - Fax:281-298-3367
Practice Address - Street 1:8845 SIX PINES DR STE 201
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-465-1767
Practice Address - Fax:281-298-3367
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist