Provider Demographics
NPI:1952586281
Name:WAHLER, ROBERT H (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:H
Last Name:WAHLER
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 1:2706 JACKSBORO HWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-1945
Mailing Address - Country:US
Mailing Address - Phone:817-626-8255
Mailing Address - Fax:817-626-1238
Practice Address - Street 1:2706 JACKSBORO HWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-1945
Practice Address - Country:US
Practice Address - Phone:817-626-8255
Practice Address - Fax:817-626-1238
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-06
Last Update Date:2008-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist