Provider Demographics
NPI:1134455769
Name:DUNLAP, RICHARD KENETH (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KENETH
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2425
Mailing Address - Country:US
Mailing Address - Phone:903-838-3988
Mailing Address - Fax:
Practice Address - Street 1:1902 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2425
Practice Address - Country:US
Practice Address - Phone:903-838-3988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist