IndividualActive
Derek Ethridge, RPH
NPI 1700478575 · Pharmacist · Lytle, TX
Provider details
- NPI number
- 1700478575
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- RPH
- Sex
- Male
- Sole proprietor
- No
- License
- 30227 (TX)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
19450 Mcdonald St Ste 102
Lytle, TX 78052-3649
Phone: (830) 988-0100
Fax: (830) 988-0111
Approximate (ZIP-level) locationGet directions
Mailing address
1757 Sunflower Blf
New Braunfels, TX 78130-1958
Registry dates
- Enumerated
- 2021-02-03
- Last updated
- 2021-02-03
- Certified
- 2021-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.