Individual
DIANE BARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1201 STONE ST, KILGORE, TX 75662-5433
(903) 983-1056
(903) 983-1242
Mailing address
11 RIM RD, KILGORE, TX 75662-2228
(903) 985-2340
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26856
TX
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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