Provider Demographics
NPI:1730803891
Name:DULANEY, MONICA RENE (RPH)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:RENE
Last Name:DULANEY
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 1:701 US HIGHWAY 259 N
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75662-6041
Mailing Address - Country:US
Mailing Address - Phone:903-983-2892
Mailing Address - Fax:
Practice Address - Street 1:701 US HIGHWAY 259 N
Practice Address - Street 2:
Practice Address - City:KILGORE
Practice Address - State:TX
Practice Address - Zip Code:75662-6041
Practice Address - Country:US
Practice Address - Phone:903-983-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist