Provider Demographics
NPI:1699370551
Name:TREMBLAY, RICHARD FARRELL (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FARRELL
Last Name:TREMBLAY
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 1:920 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-8124
Mailing Address - Country:US
Mailing Address - Phone:512-396-1111
Mailing Address - Fax:512-396-1272
Practice Address - Street 1:920 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-8124
Practice Address - Country:US
Practice Address - Phone:512-396-1111
Practice Address - Fax:512-396-1272
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist