Provider Demographics
NPI:1477945202
Name:STAGGS, MAURY EDWARD (RPH)
Entity Type:Individual
Prefix:
First Name:MAURY
Middle Name:EDWARD
Last Name:STAGGS
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 1:3917 HILLWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2528
Mailing Address - Country:US
Mailing Address - Phone:513-965-7471
Mailing Address - Fax:
Practice Address - Street 1:3917 HILLWOOD WAY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-2528
Practice Address - Country:US
Practice Address - Phone:513-965-7471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28040183500000X
LA10821183500000X
ARPD09079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist