Provider Demographics
NPI:1982717435
Name:NEACE, WILLIAM B (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:B
Last Name:NEACE
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 1:1302 S ERIC AVE
Mailing Address - Street 2:
Mailing Address - City:MONAHANS
Mailing Address - State:TX
Mailing Address - Zip Code:79756-5721
Mailing Address - Country:US
Mailing Address - Phone:143-294-3343
Mailing Address - Fax:143-294-3343
Practice Address - Street 1:801 E 4TH ST
Practice Address - Street 2:
Practice Address - City:MONAHANS
Practice Address - State:TX
Practice Address - Zip Code:79756-4018
Practice Address - Country:US
Practice Address - Phone:432-943-4212
Practice Address - Fax:432-943-7503
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist