Provider Demographics
NPI:1609481456
Name:BUTSCHEK, VICTOR FRANK JR (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:FRANK
Last Name:BUTSCHEK
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11535 OAK LAKE PARK DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7009
Mailing Address - Country:US
Mailing Address - Phone:713-299-0278
Mailing Address - Fax:
Practice Address - Street 1:11535 OAK LAKE PARK DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7009
Practice Address - Country:US
Practice Address - Phone:713-299-0278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist