Provider Demographics
NPI:1023346129
Name:WAGHWALA, PARTHIV (RPH)
Entity type:Individual
Prefix:MR
First Name:PARTHIV
Middle Name:
Last Name:WAGHWALA
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 1:156 F.M. 518 ROAD
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565
Mailing Address - Country:US
Mailing Address - Phone:281-538-3989
Mailing Address - Fax:
Practice Address - Street 1:156 FM 518 RD
Practice Address - Street 2:
Practice Address - City:KEMAH
Practice Address - State:TX
Practice Address - Zip Code:77565-3215
Practice Address - Country:US
Practice Address - Phone:281-538-3989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist