Basic Information
Provider Information
NPI: 1184662959
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCNATTY
FirstName: DANNY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5809 3RD ST
Address2: APT 308
City: LUBBOCK
State: TX
PostalCode: 794161715
CountryCode: US
TelephoneNumber: 8063926686
FaxNumber:  
Practice Location
Address1: 3601 4TH ST
Address2: STOP 8162
City: LUBBOCK
State: TX
PostalCode: 794300002
CountryCode: US
TelephoneNumber: 8067434200
FaxNumber: 8067434209
Other Information
ProviderEnumerationDate: 06/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X43329TXY Pharmacy Service ProvidersPharmacist 

No ID Information.


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