Provider Demographics
NPI:1437488913
Name:SCHULTZ, PREYACHAT (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PREYACHAT
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 S LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4730
Mailing Address - Country:US
Mailing Address - Phone:512-443-7534
Mailing Address - Fax:512-443-0447
Practice Address - Street 1:2501 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4730
Practice Address - Country:US
Practice Address - Phone:512-443-7534
Practice Address - Fax:512-443-0447
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2009-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist