James Irick Tredway, PHARMD

Individual provider Active NPI Pharmacist · Hawkins, TX

NPI 1962840710 · NPPES record last updated Jun 13, 2013

Key facts

NPI
1962840710
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
49410 (TX)
Practice address
1477 N Beaulah St
Hawkins, TX 75765-3111
Phone
(903) 769-3344
Fax
(903) 769-2885
NPI assigned
Jun 13, 2013
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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
49410TXMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 49410 TX Yes

Addresses

Primary practice location

1477 N Beaulah St
Hawkins, TX 75765-3111

Mailing address

PO Box 1011
Gilmer, TX 75644-1011

Other providers in Hawkins, TX

All providers in Hawkins, TX · Pharmacist in Texas

Sources for this page

Verify at the official NPI Registry.