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General NPI Number Information
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NPI Number | 1598808859
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Entity Type | Organization
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Legal Business Name | HOUSTON, DICKERSON, AND DICKERSON
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 502 S CRAWFORD ST
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City | CLARKSVILLE
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State | AR
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Zip | 72830-4006
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Country | US
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Telephone | 479-705-8407
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Fax | 479-705-1027
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Provider Business Mailing Address
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Address Line | PO BOX 1336
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City | CLARKSVILLE
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State | AR
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Zip | 72830-1336
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Country | US
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Telephone | 479-705-8407
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Fax | 479-705-1027
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BILLY DICKERSON
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Credential |
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Telephone | 479-705-8906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR20210
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License Number State | AR
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