Provider Demographics
NPI:1144820945
Name:BAUER, JOANNE B (RPH)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:B
Last Name:BAUER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 MONTCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2856
Mailing Address - Country:US
Mailing Address - Phone:972-390-2477
Mailing Address - Fax:
Practice Address - Street 1:1213 E TRINITY MILLS RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1446
Practice Address - Country:US
Practice Address - Phone:972-245-2323
Practice Address - Fax:972-245-2006
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist