Laura Ruth Brown, PHARMD
Individual provider Active NPI Pharmacist · Gladewater, TX
NPI 1972108488 · NPPES record last updated Dec 2, 2020
Key facts
- NPI
- 1972108488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 59754 (TX)
- Practice address
- 1402 E Broadway Ave
Gladewater, TX 75647-5037 - Phone
- (903) 845-2271
- NPI assigned
- Dec 2, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59754 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past |
Accepting new patients | |
| CVS Pharmacy Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 59754 | TX | Yes |
Addresses
Primary practice location
1402 E Broadway Ave
Gladewater, TX 75647-5037
Mailing address
1402 E Broadway Ave
Gladewater, TX 75647
Phone (903) 845-2271
Other providers in Gladewater, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.