Provider Demographics
NPI:1750993036
Name:WALKER, FRED EUGENE II (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:EUGENE
Last Name:WALKER
Suffix:II
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 1:1570 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-3816
Mailing Address - Country:US
Mailing Address - Phone:936-291-6764
Mailing Address - Fax:936-436-1773
Practice Address - Street 1:1570 11TH ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3816
Practice Address - Country:US
Practice Address - Phone:936-291-6764
Practice Address - Fax:936-436-1773
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist