Provider Demographics
NPI:1689791691
Name:ABELDT, BUFORD T SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:BUFORD
Middle Name:T
Last Name:ABELDT
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N JOHN REDDITT DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-2606
Mailing Address - Country:US
Mailing Address - Phone:936-639-2346
Mailing Address - Fax:936-639-2322
Practice Address - Street 1:300 N JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-2606
Practice Address - Country:US
Practice Address - Phone:936-639-2346
Practice Address - Fax:936-639-2322
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist