Provider Demographics
NPI:1548276645
Name:SPRADLING, GARY FRANK (MS, RPH)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:FRANK
Last Name:SPRADLING
Suffix:
Gender:M
Credentials:MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CYPRESS CT
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7555
Mailing Address - Country:US
Mailing Address - Phone:254-772-7403
Mailing Address - Fax:
Practice Address - Street 1:1901 SOUTH FIRST STREET
Practice Address - Street 2:CENTRAL TEXAS VETERANS HEALTH CARE SYSTEM (119T)
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504
Practice Address - Country:US
Practice Address - Phone:254-743-0887
Practice Address - Fax:254-743-0020
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist