Healthcare Provider Details

I. General information

NPI: 1023302890
Provider Name (Legal Business Name): THOMAS DARWIN PERSONS JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 BURR OAK LN
ADKINS TX
78101-2606
US

IV. Provider business mailing address

1830 BURR OAK LN
ADKINS TX
78101-2606
US

V. Phone/Fax

Practice location:
  • Phone: 830-216-7998
  • Fax:
Mailing address:
  • Phone: 830-216-7998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25775
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: