Provider Demographics
NPI:1306332523
Name:DODSON, ROY MARSHALL JR (RPH PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:MARSHALL
Last Name:DODSON
Suffix:JR
Gender:M
Credentials:RPH PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5114
Mailing Address - Country:US
Mailing Address - Phone:972-938-8233
Mailing Address - Fax:972-938-8360
Practice Address - Street 1:1200 N HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5114
Practice Address - Country:US
Practice Address - Phone:972-938-8222
Practice Address - Fax:972-938-8360
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist