Provider Demographics
NPI:1609403195
Name:RAGSDALE, JUDY BROD (RPH)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:BROD
Last Name:RAGSDALE
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 1:87 COUNTY ROAD 1571
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TX
Mailing Address - Zip Code:75563-4418
Mailing Address - Country:US
Mailing Address - Phone:903-733-4336
Mailing Address - Fax:
Practice Address - Street 1:609 LINDA DR
Practice Address - Street 2:
Practice Address - City:DAINGERFIELD
Practice Address - State:TX
Practice Address - Zip Code:75638-2115
Practice Address - Country:US
Practice Address - Phone:903-645-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist