Provider Demographics
NPI:1497228902
Name:EARP, WILLIAM CLARENCE (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLARENCE
Last Name:EARP
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 1:3289 COUNTY ROAD 268
Mailing Address - Street 2:
Mailing Address - City:BAIRD
Mailing Address - State:TX
Mailing Address - Zip Code:79504-4134
Mailing Address - Country:US
Mailing Address - Phone:972-900-9912
Mailing Address - Fax:
Practice Address - Street 1:312 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:COLEMAN
Practice Address - State:TX
Practice Address - Zip Code:76834-4214
Practice Address - Country:US
Practice Address - Phone:325-625-2178
Practice Address - Fax:325-625-3056
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27883OtherTX STATE BOARD OF PHARMACY RPH LICENSE NUMBER