Provider Demographics
NPI:1760044895
Name:ARCHER, DANA NICOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:NICOLE
Last Name:ARCHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 W MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4242
Mailing Address - Country:US
Mailing Address - Phone:281-332-2496
Mailing Address - Fax:281-332-3672
Practice Address - Street 1:251 W MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4242
Practice Address - Country:US
Practice Address - Phone:281-332-2496
Practice Address - Fax:281-332-3672
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist