Provider Demographics
NPI:1609539204
Name:WALTER, TODD A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
Last Name:WALTER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 HIGHWAY 6 # 212-230
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4876
Mailing Address - Country:US
Mailing Address - Phone:832-703-3651
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST STE 116
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3006
Practice Address - Country:US
Practice Address - Phone:713-799-1472
Practice Address - Fax:713-799-1473
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist