MEDICARE: LOYD DOUGLAS ROWE JR. 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
1	183500000X	Pharmacist	17189	TX

General Provider Information

NPI Number	:	1740434414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOYD DOUGLAS ROWE JR. RPH

Provider Business Mailing Address
First Line	:	2004 ROCKWOOD DR
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77807-2711
Country	:	US
Telephone Number	:	979-822-7618
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 DE LEE ST
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2815
Country	:	US
Telephone Number	:	979-776-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2008
Last Update Date	:	11/07/2008

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