Provider Demographics
NPI:1578683504
Name:BENDER, NORMAN HOWARD (BS,RPH)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:HOWARD
Last Name:BENDER
Suffix:
Gender:M
Credentials:BS,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 FAIRMOUNT ST
Mailing Address - Street 2:SUITE 6C
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1216
Mailing Address - Country:US
Mailing Address - Phone:214-520-2307
Mailing Address - Fax:972-851-5771
Practice Address - Street 1:3310 FAIRMOUNT ST
Practice Address - Street 2:SUITE 6C
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1216
Practice Address - Country:US
Practice Address - Phone:214-520-2307
Practice Address - Fax:972-851-5771
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist