Provider Demographics
NPI:1861576969
Name:ROE, LINDA JOYCE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JOYCE
Last Name:ROE
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 1:2 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-5927
Mailing Address - Country:US
Mailing Address - Phone:325-658-6551
Mailing Address - Fax:325-655-7218
Practice Address - Street 1:2 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5927
Practice Address - Country:US
Practice Address - Phone:325-658-6551
Practice Address - Fax:325-655-7218
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist