Provider Demographics
NPI:1427159532
Name:WILKS, VELMA LEWIS (RPH)
Entity type:Individual
Prefix:MRS
First Name:VELMA
Middle Name:LEWIS
Last Name:WILKS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15902 COUNTY ROAD 3460
Mailing Address - Street 2:
Mailing Address - City:SLATON
Mailing Address - State:TX
Mailing Address - Zip Code:79364-7942
Mailing Address - Country:US
Mailing Address - Phone:806-828-1461
Mailing Address - Fax:
Practice Address - Street 1:602 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3364
Practice Address - Country:US
Practice Address - Phone:806-775-8696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist