Healthcare Provider Details

I. General information

NPI: 1689966269
Provider Name (Legal Business Name): FRANK JOESPH KLEMENTICH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2011
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4218 CASTLE DR
SANTA FE TX
77510-6603
US

IV. Provider business mailing address

4218 CASTLE DR
SANTA FE TX
77510-6603
US

V. Phone/Fax

Practice location:
  • Phone: 281-229-2459
  • Fax:
Mailing address:
  • Phone: 281-229-2459
  • Fax: 908-243-9121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number38585
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: