Provider Demographics
NPI:1427281021
Name:IRWIN, JAMES WARREN JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WARREN
Last Name:IRWIN
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:21623 COUNTY ROAD 2219D
Mailing Address - Street 2:
Mailing Address - City:TATUM
Mailing Address - State:TX
Mailing Address - Zip Code:75691-4141
Mailing Address - Country:US
Mailing Address - Phone:903-646-2788
Mailing Address - Fax:
Practice Address - Street 1:2321 W LOOP 281
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2563
Practice Address - Country:US
Practice Address - Phone:903-297-0558
Practice Address - Fax:903-297-7496
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-29
Last Update Date:2009-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist