Provider Demographics
NPI:1033742663
Name:NASH, CECIL LEON (RPH)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:LEON
Last Name:NASH
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 1:1038 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4102
Mailing Address - Country:US
Mailing Address - Phone:972-224-0136
Mailing Address - Fax:
Practice Address - Street 1:235 E FM 1382
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2147
Practice Address - Country:US
Practice Address - Phone:972-291-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist