Individual
MR. MARK RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101
(870) 779-2750
Mailing address
103 WEST LAKE ROAD, TEXARKANA, TX 75501
(903) 908-3654
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
39194
TX
Other
Enumeration date
09/30/2016
Last updated
09/25/2024
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