Provider Demographics
NPI:1568811891
Name:BUTZKE, REBECCA JEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JEAN
Last Name:BUTZKE
Suffix:
Gender:F
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:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:LEAKEY
Mailing Address - State:TX
Mailing Address - Zip Code:78873-0685
Mailing Address - Country:US
Mailing Address - Phone:850-691-6691
Mailing Address - Fax:
Practice Address - Street 1:1025 GARNER FIELD RD
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4809
Practice Address - Country:US
Practice Address - Phone:830-278-6251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist