Individual
BRANDON LEE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
12200 S WACO AVE, GLENPOOL, OK 74033-5655
(918) 299-8052
(918) 299-8055
Mailing address
16210 S 88TH EAST AVE, BIXBY, OK 74008-3265
(918) 408-5189
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19808
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19808
OK PHARMACY LICENSE
OK
Enumeration date
09/01/2022
Last updated
09/01/2022
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