Provider Demographics
NPI:1578890158
Name:BAKER, JOE DON (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:DON
Last Name:BAKER
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 1:1115 W. NW HWY
Mailing Address - Street 2:SUITE H
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051
Mailing Address - Country:US
Mailing Address - Phone:817-481-5780
Mailing Address - Fax:817-442-0435
Practice Address - Street 1:1115 W. NW HWY
Practice Address - Street 2:SUIT H
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-481-5780
Practice Address - Fax:817-442-0435
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist