Provider Demographics
NPI:1437759750
Name:EMMERLING, DAVID KENT (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KENT
Last Name:EMMERLING
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 1:15517 S FM 225
Mailing Address - Street 2:
Mailing Address - City:DOUGLASS
Mailing Address - State:TX
Mailing Address - Zip Code:75943-5518
Mailing Address - Country:US
Mailing Address - Phone:936-556-0097
Mailing Address - Fax:
Practice Address - Street 1:WALMART PHARMACY 10-0140
Practice Address - Street 2:2500 DANIEL MCCALL DRIVE
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904
Practice Address - Country:US
Practice Address - Phone:936-639-2275
Practice Address - Fax:936-639-2772
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist