Provider Demographics
NPI:1528407251
Name:MORGAN, GREGG HARSTON (PHARMD)
Entity Type:Individual
Prefix:
First Name:GREGG
Middle Name:HARSTON
Last Name:MORGAN
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 1:511 E MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5425
Mailing Address - Country:US
Mailing Address - Phone:903-234-9502
Mailing Address - Fax:
Practice Address - Street 1:511 E MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5425
Practice Address - Country:US
Practice Address - Phone:903-234-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-16
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX026089183500000X
TX53427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist