Organization
TACKETT CUSTOM MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROGER MORRIS PHARM.D. (PIC)
(817) 441-7046
Entity
Organization
Contact information
Practice address
175 COLLEGE PARK DR, WEATHERFORD, TX 76086-6211
(817) 550-6046
(817) 550-6047
Mailing address
132 EL CHICO TRL, WILLOW PARK, TX 76087-8865
(817) 441-7046
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
28226
TX
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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