Provider Demographics
NPI:1588743975
Name:PIPER, VINCENT (RPH)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:PIPER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 TOMLIN LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-5532
Mailing Address - Country:US
Mailing Address - Phone:817-274-8222
Mailing Address - Fax:817-861-3497
Practice Address - Street 1:975 N COOPER ST
Practice Address - Street 2:C/O RAY'S PHARMACY
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5781
Practice Address - Country:US
Practice Address - Phone:817-274-8221
Practice Address - Fax:817-861-3497
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist