Provider Demographics
NPI:1467891259
Name:KING, CASEY LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:LEIGH
Last Name:KING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CASEY
Other - Middle Name:KING
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1900 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4182
Mailing Address - Country:US
Mailing Address - Phone:940-322-5492
Mailing Address - Fax:
Practice Address - Street 1:1900 9TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301
Practice Address - Country:US
Practice Address - Phone:940-322-5492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist