Provider Demographics
NPI:1326309063
Name:FISHER, HAROLD RAY (R PH)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:RAY
Last Name:FISHER
Suffix:
Gender:M
Credentials:R PH
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Other - Credentials:
Mailing Address - Street 1:103 MAIN STREET
Mailing Address - Street 2:BROOKSHIRE BROTHERS PHARMACY #75
Mailing Address - City:NORMANGEE
Mailing Address - State:TX
Mailing Address - Zip Code:77871
Mailing Address - Country:US
Mailing Address - Phone:936-396-1412
Mailing Address - Fax:936-396-1321
Practice Address - Street 1:103 MAIN STREET
Practice Address - Street 2:BROOKSHIRE BROTHERS PHARMACY #75
Practice Address - City:NORMANGEE
Practice Address - State:TX
Practice Address - Zip Code:77871
Practice Address - Country:US
Practice Address - Phone:936-396-1412
Practice Address - Fax:936-396-1321
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX16198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist