Provider Demographics
NPI:1639912835
Name:LAI, RICKY M (PHARMD)
Entity type:Individual
Prefix:
First Name:RICKY
Middle Name:M
Last Name:LAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 MAUMELLE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-1417
Mailing Address - Country:US
Mailing Address - Phone:972-533-2069
Mailing Address - Fax:
Practice Address - Street 1:6001 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4720
Practice Address - Country:US
Practice Address - Phone:972-422-9651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73856183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist