Most Relevant Information
Provider Data
| NPI Number: | 1003446394 |
| Provider Name: | ELYSE STUBBLEFIELD PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 50878 |
Most Important Dates
| Enumeration Date: | 01/25/2020 |
| Last Updated: | 01/25/2020 |
Provider Practice Location
5241 N TARRANT PKWY
FORT WORTH
TX
762446292
Practice Location Phone/Fax
| Phone: | 8173806181 |
| Fax: |
Provider Mailing Location
316 RUNNING WATER TRL
FORT WORTH
TX
761314611
Provider Mailing Phone/Fax
| Phone: | 8326067743 |
| Fax: |