Healthcare Provider Details

I. General information

NPI: 1972515534
Provider Name (Legal Business Name): WILLIAM JOSEPH PURYEAR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 MONTOPOLIS DR
AUSTIN TX
78741-6411
US

IV. Provider business mailing address

2195 PARK RD
NEW BRAUNFELS TX
78132-3228
US

V. Phone/Fax

Practice location:
  • Phone: 512-389-6712
  • Fax:
Mailing address:
  • Phone: 512-658-3476
  • Fax: 512-389-6568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number22491
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: