Provider Demographics
NPI:1881051001
Name:ALLY, ERIC (RPH)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ALLY
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 1:10530 JOHN W ELLIOTT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-2013
Mailing Address - Country:US
Mailing Address - Phone:214-387-3752
Mailing Address - Fax:214-387-3796
Practice Address - Street 1:10530 JOHN W ELLIOTT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2013
Practice Address - Country:US
Practice Address - Phone:214-387-3752
Practice Address - Fax:214-387-3796
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34431183500000X
AL18426183500000X
KY17580183500000X
OK15951183500000X
WVRP0009044183500000X
LAPST020936183500000X
AZS021134183500000X
ORRPH0014683183500000X
MAPH235744183500000X
NE14805183500000X
MST13854183500000X
TN38962183500000X
MD23819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist