Individual
CLARENCE DEWEY NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 SW COUNTY ROAD 0020, CORSICANA, TX 75110-9313
(903) 875-4955
(903) 874-2108
Mailing address
PO BOX 1755, CORSICANA, TX 75151-1755
(903) 875-4955
(903) 874-2108
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27013
PHARMACY BOARD
TX
Enumeration date
03/22/2019
Last updated
03/22/2019
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