Healthcare Provider Details

I. General information

NPI: 1629307418
Provider Name (Legal Business Name): THOMAS N PESSIA PHARM D., RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 ROUND ROCK AVE SUITE 150
ROUND ROCK TX
78681-4003
US

IV. Provider business mailing address

3321 FLAT IRON CT
LEANDER TX
78641-3258
US

V. Phone/Fax

Practice location:
  • Phone: 512-687-0368
  • Fax: 512-687-0300
Mailing address:
  • Phone: 432-664-5385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number40299
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: