Provider Demographics
NPI:1548724750
Name:WILLIS, STEVEN JAMES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:WILLIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 ENCHANTED ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-4187
Mailing Address - Country:US
Mailing Address - Phone:806-773-4578
Mailing Address - Fax:
Practice Address - Street 1:2550 BARROW ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6235
Practice Address - Country:US
Practice Address - Phone:325-698-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist