Provider Demographics
NPI:1619965092
Name:PRICE, BERNARD EARL (RPH)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:EARL
Last Name:PRICE
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 1:3638 WINGTAIL WAY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5024
Mailing Address - Country:US
Mailing Address - Phone:281-489-9575
Mailing Address - Fax:281-489-9575
Practice Address - Street 1:3638 WINGTAIL WAY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5024
Practice Address - Country:US
Practice Address - Phone:281-489-9575
Practice Address - Fax:281-489-9575
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist