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NPI 1366757031

NPI 1366757031 : WILLIAM DAVID DRAPER JR. RPH : ODESSA, TX

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General NPI Number Information
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    NPI Number           |    1366757031
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM DAVID DRAPER JR. RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/18/2010
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    Last Update Date     |    06/11/2012
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Provider Practice Location Address
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    Address Line         |    4950 E 42ND ST 
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    City                 |    ODESSA
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    State                |    TX
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    Zip                  |    79762-7240
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    Country              |    US
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    Telephone            |    432-367-4612
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    301 SKYWOOD 
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    City                 |    MIDLAND
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    State                |    TX
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    Zip                  |    79705-2948
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    Country              |    US
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    Telephone            |    432-685-1220
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    21533
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    License Number State |    TX
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