Provider Demographics
NPI:1043205263
Name:MCCALL, KENNETH L III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:MCCALL
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:1300 S COULTER ST
Mailing Address - Street 2:OFFICE 321
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1712
Mailing Address - Country:US
Mailing Address - Phone:806-356-4000
Mailing Address - Fax:806-356-4018
Practice Address - Street 1:1300 S COULTER ST
Practice Address - Street 2:OFFICE 321
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1712
Practice Address - Country:US
Practice Address - Phone:806-356-4000
Practice Address - Fax:806-356-4018
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX375171835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy