Provider Demographics
NPI:1194221838
Name:SMITHWICK, PRESLEY STRANGE IV (RPH)
Entity Type:Individual
Prefix:
First Name:PRESLEY
Middle Name:STRANGE
Last Name:SMITHWICK
Suffix:IV
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 1:6020 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3102
Mailing Address - Country:US
Mailing Address - Phone:806-784-1460
Mailing Address - Fax:806-784-1451
Practice Address - Street 1:6020 34TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3102
Practice Address - Country:US
Practice Address - Phone:806-784-1460
Practice Address - Fax:806-784-1451
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist