Provider Demographics
NPI:1700419975
Name:SOK, PETER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:SOK
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 1:536 CENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5147
Mailing Address - Country:US
Mailing Address - Phone:972-437-2478
Mailing Address - Fax:972-437-2675
Practice Address - Street 1:536 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5147
Practice Address - Country:US
Practice Address - Phone:972-437-2478
Practice Address - Fax:972-437-2675
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX312911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist