Provider Demographics
NPI:1659440568
Name:WARD, PHILLIP KRAMER
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:KRAMER
Last Name:WARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 FAIRVIEW LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2619
Mailing Address - Country:US
Mailing Address - Phone:432-631-3778
Mailing Address - Fax:432-684-8945
Practice Address - Street 1:2407 FAIRVIEW LN
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-2619
Practice Address - Country:US
Practice Address - Phone:432-631-3778
Practice Address - Fax:432-684-8945
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0088781332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies