Provider Demographics
NPI:1497160964
Name:NEWTON, RICARDO (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:
Last Name:NEWTON
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 1:6619 FOREST HILL DR.
Mailing Address - Street 2:SUITE 20
Mailing Address - City:FOREST HILL
Mailing Address - State:TX
Mailing Address - Zip Code:76140-1260
Mailing Address - Country:US
Mailing Address - Phone:817-478-9191
Mailing Address - Fax:817-572-0740
Practice Address - Street 1:6619 FOREST HILL DR.
Practice Address - Street 2:SUITE 20
Practice Address - City:FOREST HILL
Practice Address - State:TX
Practice Address - Zip Code:76140-1260
Practice Address - Country:US
Practice Address - Phone:817-478-9191
Practice Address - Fax:817-572-0740
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist