Provider Demographics
NPI:1568790442
Name:SAMBOLA, DANNY JR (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:
Last Name:SAMBOLA
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6721 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5744
Mailing Address - Country:US
Mailing Address - Phone:512-707-8245
Mailing Address - Fax:512-370-7767
Practice Address - Street 1:6721 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5744
Practice Address - Country:US
Practice Address - Phone:512-707-8245
Practice Address - Fax:512-707-7675
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist