Provider Demographics
NPI:1073725289
Name:SCHNEIDER, DARRELL LYNN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:LYNN
Last Name:SCHNEIDER
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 1:423 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661-2367
Mailing Address - Country:US
Mailing Address - Phone:254-883-2451
Mailing Address - Fax:254-883-5267
Practice Address - Street 1:423 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661-2367
Practice Address - Country:US
Practice Address - Phone:254-883-2451
Practice Address - Fax:254-883-5267
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist