Dr. Matt Edrick C. Bactad, Pharm.D.
Pharmacist in Lufkin, TX. Individual provider (NPI-1).
NPI number1164022190
StatusActive
Last updated in NPPESOct 28, 2020
Details
- NPI
- 1164022190
- Entity type
- Individual (NPI-1)
- Name
- Dr. Matt Edrick C. Bactad
- Credential
- Pharm.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 28, 2020
- Certification date
- Oct 28, 2020
- Last updated
- Oct 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 63709 | TX | Yes |
Practice location
407 N BrentwoodLufkin, TX 75904-7126
Phone 936-639-1748 · Fax 936-639-1750
Mailing address
407 N BrentwoodLufkin, TX 75904-7126
Phone 936-639-1748 · Fax 936-639-1750
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