MEDICARE: DR. JOHN B DYER PHARM. D, RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	42252	TX

General Provider Information

NPI Number	:	1396772927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN B DYER PHARM. D, RPH

Provider Business Mailing Address
First Line	:	11540 EAGLE DR STE A
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77523-7654
Country	:	US
Telephone Number	:	281-576-0106
Fax Number	:	281-576-5511

Provider Business Practice Location Address
First Line	:	11540 EAGLE DR STE A
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77523-7654
Country	:	US
Telephone Number	:	281-576-0106
Fax Number	:	281-576-5511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	01/04/2016

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