Provider Demographics
NPI:1316151947
Name:FREEMAN, PHILIP C (R,PH)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:C
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:R,PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 DRAKE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3007
Mailing Address - Country:US
Mailing Address - Phone:972-783-1245
Mailing Address - Fax:
Practice Address - Street 1:111 N PLANO RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3827
Practice Address - Country:US
Practice Address - Phone:972-234-5354
Practice Address - Fax:972-671-0689
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX24097OtherTX BOARD OF PHARMACY