Provider Demographics
NPI:1508211491
Name:WISER, JOSHUA EDWIN (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:EDWIN
Last Name:WISER
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 FT RICHARDSON AVE
Mailing Address - Street 2:
Mailing Address - City:GOODFELLOW AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76908
Mailing Address - Country:US
Mailing Address - Phone:325-654-5758
Mailing Address - Fax:
Practice Address - Street 1:271 FORT RICHARDSON AVE
Practice Address - Street 2:
Practice Address - City:GOODFELLOW AFB
Practice Address - State:TX
Practice Address - Zip Code:76908
Practice Address - Country:US
Practice Address - Phone:325-654-5758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX564781835P0018X, 1835P1200X
KS1-166541835P1200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy