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Individual

KENNETH CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2201 W GRAUWYLER RD, IRVING, TX 75061-4345
(972) 790-5747
Mailing address
2201 W GRAUWYLER RD, IRVING, TX 75061-4345
(972) 790-5747

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
36190
TX

Other

Enumeration date
02/09/2020
Last updated
11/08/2021
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