Provider Demographics
NPI:1720329444
Name:HORANY, MITCHELL SAM (RPH)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:SAM
Last Name:HORANY
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 1:313 SIDNEY BAKER ST S
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5916
Mailing Address - Country:US
Mailing Address - Phone:830-792-5460
Mailing Address - Fax:830-792-5464
Practice Address - Street 1:313 SIDNEY BAKER ST S
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5916
Practice Address - Country:US
Practice Address - Phone:830-792-5460
Practice Address - Fax:830-792-5464
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist