Leslie Williams
Individual provider Active NPI Pharmacist · Bacliff, TX
NPI 1801427166 · NPPES record last updated Jan 27, 2020
Key facts
- NPI
- 1801427166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26997 (TX)
- Practice address
- 1140 Grand Ave
Bacliff, TX 77518-2760 - Phone
- (281) 339-4577
- NPI assigned
- Jan 27, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26997 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sullivan S Drug LLC | Past |
Accepting new patients | |
| Sullivan S Drug LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26997 | TX | Yes |
Addresses
Primary practice location
1140 Grand Ave
Bacliff, TX 77518-2760
Mailing address
3043 Longwood LN
Dickinson, TX 77539-4400
Other providers in Bacliff, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.