Provider Demographics
NPI:1598351249
Name:BATES, BRIAN (RPH)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:BATES
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 1:717 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-5337
Mailing Address - Country:US
Mailing Address - Phone:903-938-6741
Mailing Address - Fax:903-938-0351
Practice Address - Street 1:717 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5337
Practice Address - Country:US
Practice Address - Phone:903-938-6741
Practice Address - Fax:903-938-0351
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist