Healthcare Provider Details

I. General information

NPI: 1356328603
Provider Name (Legal Business Name): DAVID JEREMY SOHL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10651 E ST NAVAL HOSPITAL CORPUS CHRISTI PHARMACY
CORPUS CHRISTI TX
78419-5130
US

IV. Provider business mailing address

6013 STETSON CIR
CORPUS CHRISTI TX
78414-3000
US

V. Phone/Fax

Practice location:
  • Phone: 361-961-6053
  • Fax: 361-961-2499
Mailing address:
  • Phone: 361-961-6053
  • Fax: 361-961-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19958
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number43014
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: