Individual
MRS. ANGELA S WHATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1026 HALSELL ST, BRIDGEPORT, TX 76426-3030
(940) 683-2950
(940) 683-8059
Mailing address
1037 COUNTY ROAD 4781, BOYD, TX 76023-5430
(940) 399-8577
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
290101040752404
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125962
CPHT
TX
Enumeration date
08/18/2006
Last updated
07/08/2007
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