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NPI Code Detail

MEDICARE: ETHAN GREGORY MERRIFIELD PHARMD

MEDICARE: ETHAN GREGORY MERRIFIELD PHARMD
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
1183500000XPharmacist77316TX

General Provider Information

NPI Number : 1962328575
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETHAN GREGORY MERRIFIELD PHARMD
Provider Business Mailing Address
First Line : 8610 SOUTHWESTERN BLVD APT 1208
Second Line :
City : DALLAS
State : TX
Zip : 75206-2642
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4500 S LANCASTER RD
Second Line :
City : DALLAS
State : TX
Zip : 75216-7167
Country : US
Telephone Number : 214-742-8387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2026
Last Update Date : 06/26/2026

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