Provider Demographics
NPI:1043797483
Name:STEARNS, JAY LYNN
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:LYNN
Last Name:STEARNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 W ARAPAHO RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5045
Mailing Address - Country:US
Mailing Address - Phone:972-680-9717
Mailing Address - Fax:972-231-3159
Practice Address - Street 1:819 W ARAPAHO RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5045
Practice Address - Country:US
Practice Address - Phone:972-680-9717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist