Provider Demographics
NPI:1962003400
Name:GIDDENS, ROBERT KIRK (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KIRK
Last Name:GIDDENS
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 1:608 TETON DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6415
Mailing Address - Country:US
Mailing Address - Phone:903-466-6225
Mailing Address - Fax:
Practice Address - Street 1:608 TETON DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6415
Practice Address - Country:US
Practice Address - Phone:903-466-6225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31478183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist