Provider Demographics
NPI:1649515263
Name:AMMONS, WILLIAM BRANDON (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRANDON
Last Name:AMMONS
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 1:2751 N COUNTY RD W
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79764-1665
Mailing Address - Country:US
Mailing Address - Phone:432-333-1591
Mailing Address - Fax:432-335-0839
Practice Address - Street 1:2751 N COUNTY RD W
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79764-1665
Practice Address - Country:US
Practice Address - Phone:432-333-1591
Practice Address - Fax:432-335-0839
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist