Provider Demographics
NPI:1003276452
Name:BUECHE, JAY (RPH)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:BUECHE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 S FLORES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-1219
Mailing Address - Country:US
Mailing Address - Phone:210-938-8578
Mailing Address - Fax:210-938-8832
Practice Address - Street 1:646 S FLORES ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78204-1219
Practice Address - Country:US
Practice Address - Phone:210-938-8578
Practice Address - Fax:210-938-8832
Is Sole Proprietor?:No
Enumeration Date:2016-02-28
Last Update Date:2016-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist