Individual
DAVID THANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2610 RICHMOND RD, TEXARKANA, TX 75503-2327
(903) 832-2258
Mailing address
2610 RICHMOND RD, TEXARKANA, TX 75503-2327
(903) 832-2258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463944
—
TX
Enumeration date
07/01/2015
Last updated
07/01/2015
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