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NPI Code Detail

MEDICARE: DR. WILLARD LEE PODLEY PHARM. D

MEDICARE: DR. WILLARD LEE PODLEY PHARM. D
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
1183500000XPharmacist47477TX
2183500000XPharmacistPD11097AR

General Provider Information

NPI Number : 1760777387
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLARD LEE PODLEY PHARM. D
Provider Business Mailing Address
First Line : 1300 E CAMPBELL RD
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-1937
Country : US
Telephone Number : 972-813-3600
Fax Number :
Provider Business Practice Location Address
First Line : 1300 E CAMPBELL RD
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-1937
Country : US
Telephone Number : 972-813-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2011
Last Update Date : 11/17/2011

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