Provider Demographics
NPI:1417074543
Name:PATRICK, RONALD KEVIN (RPH, MBA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:KEVIN
Last Name:PATRICK
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:MR
Other - First Name:RONALD
Other - Middle Name:KEVIN
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH, MBA
Mailing Address - Street 1:709 GREGORY ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5414
Mailing Address - Country:US
Mailing Address - Phone:972-278-3944
Mailing Address - Fax:
Practice Address - Street 1:7310 S WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2998
Practice Address - Country:US
Practice Address - Phone:972-709-3594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320601835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric