Provider Demographics
NPI:1548512411
Name:LEMONS, WALDRICK LYNN (RPH)
Entity type:Individual
Prefix:MR
First Name:WALDRICK
Middle Name:LYNN
Last Name:LEMONS
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 1:413 MAUMEE RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-6430
Mailing Address - Country:US
Mailing Address - Phone:972-998-1422
Mailing Address - Fax:
Practice Address - Street 1:413 MAUMEE RD
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-6430
Practice Address - Country:US
Practice Address - Phone:972-998-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist