Provider Demographics
NPI:1881921922
Name:MCCARVER, LARRY GLEN (RPH)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:GLEN
Last Name:MCCARVER
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 1:1152 WILDEMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3834
Mailing Address - Country:US
Mailing Address - Phone:409-673-4885
Mailing Address - Fax:
Practice Address - Street 1:902 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7359
Practice Address - Country:US
Practice Address - Phone:409-755-2858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist