Mayberry, Gary
Mayberry, Gary is an sole proprietor health care provider with primary practice located at 1317 E Us Highway 175 , Crandall TX 75114-2549. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Mayberry, Gary can be contacted via phone (972) 427-6442.Contact Information
Primary practice address
1317 E Us Highway 175
Crandall TX 75114-2549
Phone: (972) 427-6442
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 22606 | Texas |
Profile Details
| NPI number | 1164180444 |
|---|---|
| LBN Legal business name | Mayberry, Gary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 3rd, 2021 |
| Last updated | Dec 3rd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164180444 | NPPES |
| Other | 0634865 | DRIVERS LICENSE |
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