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NPI Code Detail

MEDICARE: GWENDOLYN LEE WALKER RPH

MEDICARE: GWENDOLYN LEE WALKER RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist29256TX

General Provider Information

NPI Number : 1225343437
Entity Type Code : Individual
Provider Name (Legal Business Name) : GWENDOLYN LEE WALKER RPH
Provider Business Mailing Address
First Line : 136 SUBURBAN DR
Second Line :
City : OVILLA
State : TX
Zip : 75154-1628
Country : US
Telephone Number : 972-740-4287
Fax Number :
Provider Business Practice Location Address
First Line : 201 S 15TH ST
Second Line :
City : CORSICANA
State : TX
Zip : 75110-5138
Country : US
Telephone Number : 903-874-6546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2010
Last Update Date : 08/11/2010

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