Provider Demographics
NPI:1629531397
Name:ALLARD, TERRY (RPH)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:ALLARD
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 1:2812 WINGREN RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4518
Mailing Address - Country:US
Mailing Address - Phone:214-755-6386
Mailing Address - Fax:
Practice Address - Street 1:2812 WINGREN RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4518
Practice Address - Country:US
Practice Address - Phone:214-755-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist