Provider Demographics
NPI:1417196882
Name:BARRETT, WAYMON (RPH)
Entity Type:Individual
Prefix:MR
First Name:WAYMON
Middle Name:
Last Name:BARRETT
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 1:4040 1/2 YALE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022
Mailing Address - Country:US
Mailing Address - Phone:713-504-5199
Mailing Address - Fax:
Practice Address - Street 1:4040 1/2 YALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-5928
Practice Address - Country:US
Practice Address - Phone:713-504-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18099183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist