Provider Demographics
NPI:1336749837
Name:GOINS, KEVIN L (RPH)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:L
Last Name:GOINS
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 1:8202 ITHACA DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4423
Mailing Address - Country:US
Mailing Address - Phone:214-476-1601
Mailing Address - Fax:
Practice Address - Street 1:8520 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4918
Practice Address - Country:US
Practice Address - Phone:817-514-9524
Practice Address - Fax:817-514-9439
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy