Provider Demographics
NPI:1508993916
Name:TODD, RICHARD ARLINGTON (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ARLINGTON
Last Name:TODD
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 1:124 S MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75654-3520
Mailing Address - Country:US
Mailing Address - Phone:903-657-8536
Mailing Address - Fax:903-657-0047
Practice Address - Street 1:124 S MARSHALL ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654-3520
Practice Address - Country:US
Practice Address - Phone:903-657-8536
Practice Address - Fax:903-657-0047
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142006Medicaid