Provider Demographics
NPI:1093519498
Name:GARRARD, BRYSAN ANDREW (PHARMD)
Entity type:Individual
Prefix:
First Name:BRYSAN
Middle Name:ANDREW
Last Name:GARRARD
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 HILLCREST DR STE B
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-3194
Mailing Address - Country:US
Mailing Address - Phone:940-552-9501
Mailing Address - Fax:940-552-2075
Practice Address - Street 1:1015 HILLCREST DR STE B
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-3194
Practice Address - Country:US
Practice Address - Phone:940-552-9501
Practice Address - Fax:940-552-2075
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist