Provider Demographics
NPI:1033134788
Name:HUTMACHER, DUSTIN SHAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:SHAY
Last Name:HUTMACHER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 S ASH CV
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5542
Mailing Address - Country:US
Mailing Address - Phone:512-828-7880
Mailing Address - Fax:
Practice Address - Street 1:119 ED SCHMIDT BLVD
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5557
Practice Address - Country:US
Practice Address - Phone:512-759-3739
Practice Address - Fax:512-846-1790
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2009-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 54219183500000X
TX461124183500000X
NE11827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist