Individual
MRS. REBECCA ELIZABETH PEGUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACY TECH
Contact information
Practice address
1469 W STATE HIGHWAY 114, SUITE # 598, GRAPEVINE, TX 76051-8625
(817) 571-8745
Mailing address
304 RANDY RD, ROANOKE, TX 76262-6149
(817) 807-1443
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2301-0102-0754-276
TX
Other
Enumeration date
03/19/2007
Last updated
01/10/2012
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