Provider Demographics
NPI:1831799212
Name:ROCHA, CHRISTIAN RYAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:RYAN
Last Name:ROCHA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 E RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6017
Mailing Address - Country:US
Mailing Address - Phone:817-274-1090
Mailing Address - Fax:817-274-0821
Practice Address - Street 1:915 E RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-6017
Practice Address - Country:US
Practice Address - Phone:817-274-1090
Practice Address - Fax:817-274-0821
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist