Provider Demographics
NPI:1881294445
Name:HARPER, DEMELIUS SHOMBRAE (PHARMD)
Entity type:Individual
Prefix:
First Name:DEMELIUS
Middle Name:SHOMBRAE
Last Name:HARPER
Suffix:
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 1:10928 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3113
Mailing Address - Country:US
Mailing Address - Phone:469-867-2257
Mailing Address - Fax:214-705-1421
Practice Address - Street 1:1951 MILITARY PKWY
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3629
Practice Address - Country:US
Practice Address - Phone:469-357-5453
Practice Address - Fax:469-357-5452
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist