Provider Demographics
NPI:1619247483
Name:LITICKER, JEFF D (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:D
Last Name:LITICKER
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2201 INWOOD RD
Mailing Address - Street 2:NC2.852
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7320
Mailing Address - Country:US
Mailing Address - Phone:214-645-2681
Mailing Address - Fax:214-645-2673
Practice Address - Street 1:2201 INWOOD RD
Practice Address - Street 2:NC2.852
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7320
Practice Address - Country:US
Practice Address - Phone:214-645-2681
Practice Address - Fax:214-645-2673
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320491835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology