Provider Demographics
NPI:1447246442
Name:MICK, LINDA CAROL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:CAROL
Last Name:MICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3801 E 42ND ST
Mailing Address - Street 2:HEB PHARMACY
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5947
Mailing Address - Country:US
Mailing Address - Phone:432-614-4306
Mailing Address - Fax:432-614-4356
Practice Address - Street 1:3801 E 42ND ST
Practice Address - Street 2:HEB PHARMACY
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5947
Practice Address - Country:US
Practice Address - Phone:432-362-4555
Practice Address - Fax:432-362-4514
Is Sole Proprietor?:No
Enumeration Date:2005-09-25
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX42585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist