Provider Demographics
NPI:1790991552
Name:DEAVER, WILLIAM DUANE (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DUANE
Last Name:DEAVER
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 1:4012 ECHORIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1643
Mailing Address - Country:US
Mailing Address - Phone:214-731-0506
Mailing Address - Fax:214-731-0506
Practice Address - Street 1:6200 W PARKER RD
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7939
Practice Address - Country:US
Practice Address - Phone:972-981-8743
Practice Address - Fax:972-981-8020
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist