Provider Demographics
NPI:1760777387
Name:PODLEY, WILLARD LEE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:LEE
Last Name:PODLEY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-1937
Mailing Address - Country:US
Mailing Address - Phone:972-813-3600
Mailing Address - Fax:
Practice Address - Street 1:1300 E CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1937
Practice Address - Country:US
Practice Address - Phone:972-813-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47477183500000X
ARPD11097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist