Provider Demographics
NPI:1609423474
Name:FINK, TARA LIANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LIANNE
Last Name:FINK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:LIANNE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8401 SANDHILL CRANE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76118-4601
Mailing Address - Country:US
Mailing Address - Phone:817-201-6191
Mailing Address - Fax:
Practice Address - Street 1:6401 NE LOOP 820
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6041
Practice Address - Country:US
Practice Address - Phone:817-498-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist