Provider Demographics
NPI:1245386606
Name:PITTMAN, BILL C (RPH)
Entity Type:Individual
Prefix:MR
First Name:BILL
Middle Name:C
Last Name:PITTMAN
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 1:82 GRASSMARKET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2261
Mailing Address - Country:US
Mailing Address - Phone:210-481-3601
Mailing Address - Fax:210-481-3602
Practice Address - Street 1:82 GRASSMARKET
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2261
Practice Address - Country:US
Practice Address - Phone:210-481-3601
Practice Address - Fax:210-481-3602
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist