Provider Demographics
NPI:1184647919
Name:MACLAYTON, DAREGO O (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAREGO
Middle Name:O
Last Name:MACLAYTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CLEBURNE AVE
Mailing Address - Street 2:COLLEGE OF PHARMACY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:713-313-1224
Mailing Address - Fax:713-313-1209
Practice Address - Street 1:3100 CLEBURNE AVE
Practice Address - Street 2:COLLEGE OF PHARMACY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004
Practice Address - Country:US
Practice Address - Phone:713-313-1224
Practice Address - Fax:713-313-1209
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist