Provider Demographics
NPI:1326453549
Name:DEMARCO, WILLIAM CARMELO (PHARMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CARMELO
Last Name:DEMARCO
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 1:5200 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-4906
Mailing Address - Country:US
Mailing Address - Phone:915-778-0680
Mailing Address - Fax:915-778-0883
Practice Address - Street 1:5200 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4906
Practice Address - Country:US
Practice Address - Phone:915-778-0680
Practice Address - Fax:915-778-0883
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801833363OtherEMPLOYER NPI
TX54066OtherTEXAS STATE BOARD OF PHARMACY
OH03438467OtherOHIO STATE BOARD OF PHARMACY
TX22627OtherEMPLOYER LICENSE NUMBER