Provider Demographics
NPI:1487369070
Name:FEIN, JACQUELINE LEE
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:LEE
Last Name:FEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:LEE
Other - Last Name:SHARTSIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1259 FM 1463 STE. 700
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494
Mailing Address - Country:US
Mailing Address - Phone:281-985-1418
Mailing Address - Fax:281-985-1416
Practice Address - Street 1:1259 FM 1463 STE. 700
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-985-1418
Practice Address - Fax:281-985-1416
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist