Provider Demographics
NPI:1932426749
Name:JAMES, RICKY DALE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICKY
Middle Name:DALE
Last Name:JAMES
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 1:603 LOUIS HENNA BLVD # A
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-7186
Mailing Address - Country:US
Mailing Address - Phone:512-828-0814
Mailing Address - Fax:512-828-0854
Practice Address - Street 1:603 LOUIS HENNA BLVD # A
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-7186
Practice Address - Country:US
Practice Address - Phone:512-828-0814
Practice Address - Fax:512-828-0854
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist