Provider Demographics
NPI:1497351555
Name:PALMER, MCWADE NORRIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:MCWADE
Middle Name:NORRIS
Last Name:PALMER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19211 BULLARD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5214
Mailing Address - Country:US
Mailing Address - Phone:281-814-4083
Mailing Address - Fax:
Practice Address - Street 1:19211 BULLARD CREEK DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5214
Practice Address - Country:US
Practice Address - Phone:281-814-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist