Provider Demographics
NPI:1336674449
Name:MORGAN, TIMOTHY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:MORGAN
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 1:7524 BOSQUE BLVD STE N&O
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3779
Mailing Address - Country:US
Mailing Address - Phone:254-776-6398
Mailing Address - Fax:800-306-3277
Practice Address - Street 1:7524 BOSQUE BLVD STE N&O
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3779
Practice Address - Country:US
Practice Address - Phone:254-776-6398
Practice Address - Fax:800-306-3277
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist