Provider Demographics
NPI:1750457057
Name:WACHSMANN, JOE F (RPH)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:F
Last Name:WACHSMANN
Suffix:
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 1:3211 ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-4409
Mailing Address - Country:US
Mailing Address - Phone:254-662-0774
Mailing Address - Fax:
Practice Address - Street 1:3211 ROBINSON DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-4409
Practice Address - Country:US
Practice Address - Phone:254-662-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist