Provider Demographics
NPI:1689287310
Name:HARPER, NYLA (RPH)
Entity Type:Individual
Prefix:
First Name:NYLA
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 MASON CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS
Practice Address - Street 2:1000 CENTRAL TEXAS EXPRESSWAY
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541
Practice Address - Country:US
Practice Address - Phone:254-526-4258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32259OtherPHARMACY LICENSE