Provider Demographics
NPI:1265769046
Name:WARD, ROBERT LLOYD (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LLOYD
Last Name:WARD
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 1:1902 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2425
Mailing Address - Country:US
Mailing Address - Phone:903-838-3988
Mailing Address - Fax:903-838-4013
Practice Address - Street 1:1902 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2425
Practice Address - Country:US
Practice Address - Phone:903-838-3988
Practice Address - Fax:903-838-4013
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist