Gretchen Lynn Fabiano

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Crowley, TX

NPI 1104456433 · NPPES record last updated Jan 26, 2020

Key facts

NPI
1104456433
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
33030 (TX)
Practice address
1004 S Crowley Rd
Crowley, TX 76036-3670
Phone
(817) 297-0006
NPI assigned
Jan 26, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
33030TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Texas LP Past
since Feb 2, 2020
Accepting new patients
Kroger Texas L P Past
since Feb 2, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 33030 TX Yes

Addresses

Primary practice location

1004 S Crowley Rd
Crowley, TX 76036-3670

Mailing address

1004 S Crowley Rd
Crowley, TX 76036-3670
Phone (817) 297-0006

Other providers in Crowley, TX

All providers in Crowley, TX · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Texas

Sources for this page

Verify at the official NPI Registry.