Provider Demographics
NPI:1710290341
Name:ADASZCZYK, CHARLES JONATHON (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:JONATHON
Last Name:ADASZCZYK
Suffix:
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 1:26107 HOOTANANNY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-6250
Mailing Address - Country:US
Mailing Address - Phone:830-980-5766
Mailing Address - Fax:
Practice Address - Street 1:14087 OCONNOR RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1979
Practice Address - Country:US
Practice Address - Phone:210-637-0033
Practice Address - Fax:210-590-6486
Is Sole Proprietor?:No
Enumeration Date:2010-07-25
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist