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NPI Code Detail

MEDICARE: CHRISTY DIERSCHKE

MEDICARE: CHRISTY DIERSCHKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist35175TX

General Provider Information

NPI Number : 1306175575
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTY DIERSCHKE
Provider Business Mailing Address
First Line : 5600 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78745-3108
Country : US
Telephone Number : 512-441-4747
Fax Number : 512-441-2727
Provider Business Practice Location Address
First Line : 5600 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78745-3108
Country : US
Telephone Number : 512-441-4747
Fax Number : 512-441-2727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2009
Last Update Date : 12/16/2009

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Directions to “ CHRISTY DIERSCHKE ” Practice Location

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