Healthcare Provider Details

I. General information

NPI: 1700114568
Provider Name (Legal Business Name): THOMAS MICHEAL HOHENSEE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2009
Last Update Date: 12/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 BOONVILLE RD
BRYAN TX
77808-2225
US

IV. Provider business mailing address

17003 PAINTED SUNSET CT
COLLEGE STATION TX
77845-7165
US

V. Phone/Fax

Practice location:
  • Phone: 979-731-1401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42343
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: