Sean Wood, PHARMACY TECH

Individual provider Active NPI Pharmacy Technician · Texarkana, TX

NPI 1306301957 · NPPES record last updated Feb 7, 2019

Key facts

NPI
1306301957
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
108620 (TX)
Practice address
3002 Moores LN
Texarkana, TX 75503-2204
Phone
(430) 200-4350
Fax
(833) 491-2722
NPI assigned
Feb 7, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
108620TXMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 108620 TX Yes

Addresses

Primary practice location

3002 Moores LN
Texarkana, TX 75503-2204

Mailing address

3002 Moores LN
Texarkana, TX 75503-2204
Phone (430) 200-4350

Other providers in Texarkana, TX

All providers in Texarkana, TX · Pharmacy Technician in Texas

Sources for this page

Verify at the official NPI Registry.