Provider Demographics
NPI:1326374950
Name:HALTER, RICHARD VOLPOE JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:VOLPOE
Last Name:HALTER
Suffix:JR
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 1:4415 N STATELINE AVE
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3138
Mailing Address - Country:US
Mailing Address - Phone:903-792-8918
Mailing Address - Fax:903-792-6918
Practice Address - Street 1:4415 N STATELINE AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3138
Practice Address - Country:US
Practice Address - Phone:903-792-8918
Practice Address - Fax:903-792-6918
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist