Provider Demographics
NPI:1992305726
Name:EMBREE, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:EMBREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5382
Mailing Address - Country:US
Mailing Address - Phone:972-849-4414
Mailing Address - Fax:
Practice Address - Street 1:15220 MONTFORT RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-6401
Practice Address - Country:US
Practice Address - Phone:972-233-8764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist