Provider Demographics
NPI:1780288811
Name:HOECKER, TORY LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TORY
Middle Name:LYNN
Last Name:HOECKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-3740
Mailing Address - Country:US
Mailing Address - Phone:409-769-5423
Mailing Address - Fax:
Practice Address - Street 1:1295 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-3740
Practice Address - Country:US
Practice Address - Phone:409-769-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67525OtherTEXAS STATE BOARD OF PHARMACY