Provider Demographics
NPI:1902546997
Name:MAGRANE, DEA HOXHA
Entity Type:Individual
Prefix:
First Name:DEA
Middle Name:HOXHA
Last Name:MAGRANE
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 1:4935 ABSTON ST
Mailing Address - Street 2:
Mailing Address - City:FORT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79906-3827
Mailing Address - Country:US
Mailing Address - Phone:339-440-6998
Mailing Address - Fax:
Practice Address - Street 1:1611 HAAN RD
Practice Address - Street 2:
Practice Address - City:FORT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79906-3373
Practice Address - Country:US
Practice Address - Phone:915-742-9017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist