Provider Demographics
NPI:1740434414
Name:ROWE, LOYD DOUGLAS JR (RPH)
Entity type:Individual
Prefix:
First Name:LOYD
Middle Name:DOUGLAS
Last Name:ROWE
Suffix:JR
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 1:2004 ROCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807-2711
Mailing Address - Country:US
Mailing Address - Phone:979-822-7618
Mailing Address - Fax:
Practice Address - Street 1:2300 DE LEE ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2815
Practice Address - Country:US
Practice Address - Phone:979-776-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist