Provider Demographics
NPI:1003962457
Name:VIATOR, JAMES RANDY (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RANDY
Last Name:VIATOR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 EASTGATE LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6448
Mailing Address - Country:US
Mailing Address - Phone:972-442-0563
Mailing Address - Fax:860-754-0910
Practice Address - Street 1:5205 EASTGATE LN
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-6448
Practice Address - Country:US
Practice Address - Phone:972-442-0563
Practice Address - Fax:860-754-0910
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist