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Individual
MR. TIMOTHY S OURSBOURN
Active
Individual
MR. TIMOTHY S OURSBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
39024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39024
STATE LICENSE
TX
01
—
RP00007099
NEW MEXICO STATE BOARD OF PHARMACY
NM
Enumeration date
07/29/2006
Last updated
05/27/2015
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