Provider Demographics
NPI:1063749331
Name:OVERFIELD, BRIAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:OVERFIELD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 SOUTHWEST PKWY
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-4120
Mailing Address - Country:US
Mailing Address - Phone:940-692-3421
Mailing Address - Fax:940-692-9310
Practice Address - Street 1:2800 SOUTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-4120
Practice Address - Country:US
Practice Address - Phone:940-692-3421
Practice Address - Fax:940-692-9310
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist