Provider Demographics
NPI:1295338929
Name:FUCHSHUBER, DANIEL C SR (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:C
Last Name:FUCHSHUBER
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 1:530 MURR RD
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-1308
Mailing Address - Country:US
Mailing Address - Phone:817-846-6706
Mailing Address - Fax:
Practice Address - Street 1:1014 N FIELDER RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-3149
Practice Address - Country:US
Practice Address - Phone:817-274-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist