Healthcare Provider Details

I. General information

NPI: 1841886678
Provider Name (Legal Business Name): JAMES DAVID HUFFMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N FRONTAGE RD
LORENA TX
76655-3812
US

IV. Provider business mailing address

406 N FRONTAGE RD
LORENA TX
76655-3812
US

V. Phone/Fax

Practice location:
  • Phone: 254-857-3955
  • Fax: 254-857-4997
Mailing address:
  • Phone: 254-857-3955
  • Fax: 254-857-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28358
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: