Provider Demographics
NPI:1659650208
Name:GRIFFITH, KWAME N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KWAME
Middle Name:N
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18208 PRESTON RD STE D9306
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6007
Mailing Address - Country:US
Mailing Address - Phone:404-558-5579
Mailing Address - Fax:
Practice Address - Street 1:3092 N EASTMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-7950
Practice Address - Country:US
Practice Address - Phone:903-323-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-14
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007709183500000X
TX50909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist