Provider Demographics
NPI:1174733299
Name:WUBBENA, SHERRY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:WUBBENA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 FRANKFORD RD APT 2817
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6489
Mailing Address - Country:US
Mailing Address - Phone:214-709-5121
Mailing Address - Fax:
Practice Address - Street 1:4142 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3522
Practice Address - Country:US
Practice Address - Phone:214-599-9861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist