Provider Demographics
NPI:1710215744
Name:FORD, CAREY NEAL (RPH)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:NEAL
Last Name:FORD
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 1:7019 S ZARZAMORA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1141
Mailing Address - Country:US
Mailing Address - Phone:210-932-0138
Mailing Address - Fax:210-932-0140
Practice Address - Street 1:7019 S ZARZAMORA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1141
Practice Address - Country:US
Practice Address - Phone:210-932-0138
Practice Address - Fax:210-932-0140
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38847183500000X
LA17322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist