Provider Demographics
NPI:1720129851
Name:STEIN, E. J (RPH)
Entity Type:Individual
Prefix:MR
First Name:E.
Middle Name:J
Last Name:STEIN
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:PO BOX 868
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-0868
Mailing Address - Country:US
Mailing Address - Phone:512-756-2966
Mailing Address - Fax:512-756-7503
Practice Address - Street 1:2004 W STATE HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-2353
Practice Address - Country:US
Practice Address - Phone:512-756-2966
Practice Address - Fax:512-756-7503
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29131835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support