Provider Demographics
NPI:1932537248
Name:DYDA, RONALD DALE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DALE
Last Name:DYDA
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:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TX
Mailing Address - Zip Code:79831-0989
Mailing Address - Country:US
Mailing Address - Phone:432-837-2252
Mailing Address - Fax:432-836-3152
Practice Address - Street 1:202 E AVENUE E
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-4728
Practice Address - Country:US
Practice Address - Phone:432-837-2252
Practice Address - Fax:432-836-3152
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist