Provider Demographics
NPI:1558965822
Name:DAUFEN, NICHOLAS M (RPH)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:M
Last Name:DAUFEN
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 1:409 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-4467
Mailing Address - Country:US
Mailing Address - Phone:830-775-8538
Mailing Address - Fax:
Practice Address - Street 1:409 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4467
Practice Address - Country:US
Practice Address - Phone:830-775-8538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist