Provider Demographics
NPI:1285915231
Name:BAKER, JONATHAN ALAN (PHARM D)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ALAN
Last Name:BAKER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6155
Mailing Address - Country:US
Mailing Address - Phone:806-773-7272
Mailing Address - Fax:
Practice Address - Street 1:2025 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2911
Practice Address - Country:US
Practice Address - Phone:806-773-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist