Provider Demographics
NPI:1962139329
Name:NEWMAN, TALIE RENEE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:TALIE
Middle Name:RENEE
Last Name:NEWMAN
Suffix:
Gender:
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 N O CONNOR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5714
Mailing Address - Country:US
Mailing Address - Phone:469-282-1073
Mailing Address - Fax:
Practice Address - Street 1:5101 N O CONNOR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-5714
Practice Address - Country:US
Practice Address - Phone:469-282-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist