Provider Demographics
NPI:1316584634
Name:JONES, HENRY GLENN (RPH)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:GLENN
Last Name:JONES
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 1:100 PEPLOW DR
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-5326
Mailing Address - Country:US
Mailing Address - Phone:254-662-6403
Mailing Address - Fax:866-575-2774
Practice Address - Street 1:100 PEPLOW DR
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:TX
Practice Address - Zip Code:76706-5326
Practice Address - Country:US
Practice Address - Phone:254-662-6403
Practice Address - Fax:866-575-2774
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist