Healthcare Provider Details

I. General information

NPI: 1417074543
Provider Name (Legal Business Name): RONALD KEVIN PATRICK RPH, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RONALD KEVIN PATRICK RPH, MBA

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 S WESTMORELAND RD
DALLAS TX
75237-2998
US

IV. Provider business mailing address

709 GREGORY ST
GARLAND TX
75041-5414
US

V. Phone/Fax

Practice location:
  • Phone: 972-709-3594
  • Fax:
Mailing address:
  • Phone: 972-278-3944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number32060
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: