Bob Wallace
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Katy, TX. Individual provider (NPI-1).
NPI number1164055604
StatusActive
Last updated in NPPESFeb 12, 2020
Details
- NPI
- 1164055604
- Entity type
- Individual (NPI-1)
- Name
- Bob Wallace
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 12, 2020
- Certification date
- Feb 12, 2020
- Last updated
- Feb 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P0018X | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 30292 | TX | Yes |
Practice location
22150 Westheimer PkwyKaty, TX 77450-8296
Phone 281-828-8778
Mailing address
22150 Westheimer PkwyKaty, TX 77450-8296
Phone 281-828-8778
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