Provider Demographics
NPI:1497350847
Name:SCHLEPPENBACH, TIM (RPH)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:SCHLEPPENBACH
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 1:6338 VICKERY BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3347
Mailing Address - Country:US
Mailing Address - Phone:214-403-0124
Mailing Address - Fax:
Practice Address - Street 1:5050 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7415
Practice Address - Country:US
Practice Address - Phone:214-375-8924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist