Provider Demographics
NPI:1437883683
Name:HUDSON, TROY P (RPH)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:P
Last Name:HUDSON
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 1:1207 N LOOP 340
Mailing Address - Street 2:
Mailing Address - City:LACY LAKEVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76705-2470
Mailing Address - Country:US
Mailing Address - Phone:254-867-6700
Mailing Address - Fax:
Practice Address - Street 1:1207 N LOOP 340
Practice Address - Street 2:
Practice Address - City:LACY LAKEVIEW
Practice Address - State:TX
Practice Address - Zip Code:76705-2470
Practice Address - Country:US
Practice Address - Phone:254-867-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09960183500000X
TX43617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist