Provider Demographics
NPI:1689018418
Name:DRZYMALA, BRANDI N (RPH)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:N
Last Name:DRZYMALA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6773 STATE HIGHWAY 119
Mailing Address - Street 2:
Mailing Address - City:STOCKDALE
Mailing Address - State:TX
Mailing Address - Zip Code:78160-6761
Mailing Address - Country:US
Mailing Address - Phone:210-618-9639
Mailing Address - Fax:
Practice Address - Street 1:14414 US HIGHWAY 87 W
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-5922
Practice Address - Country:US
Practice Address - Phone:830-779-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist