Individual
CHARLES RAY ELLEXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1201 E 9TH ST, BONHAM, TX 75418-4059
(903) 583-6787
Mailing address
4774 OLD HIGHWAY 70, DURANT, OK 74701-0704
(580) 924-4549
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28257
TX
183500000X
Pharmacist
8283
OK
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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