Provider Demographics
NPI:1578623450
Name:PRICE-BURKE, RICARDA PATRICE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RICARDA
Middle Name:PATRICE
Last Name:PRICE-BURKE
Suffix:
Gender:F
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:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:TEAGUE
Mailing Address - State:TX
Mailing Address - Zip Code:75860-0062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 MILES WEST HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-1132
Practice Address - Country:US
Practice Address - Phone:254-562-2821
Practice Address - Fax:254-562-1430
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist