Provider Demographics
NPI:1801662432
Name:MORGAN, MACY CALICUTT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MACY
Middle Name:CALICUTT
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MACY
Other - Middle Name:CLAIRE
Other - Last Name:CALICUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3828 TROUP HWY
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1726
Mailing Address - Country:US
Mailing Address - Phone:903-581-9666
Mailing Address - Fax:903-581-5316
Practice Address - Street 1:3828 TROUP HWY
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1726
Practice Address - Country:US
Practice Address - Phone:903-581-9666
Practice Address - Fax:903-581-5316
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist