Healthcare Provider Details

I. General information

NPI: 1508083924
Provider Name (Legal Business Name): DAVID W SCHATZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 EAST JEFFERSON ST.
VAN ALSTYNE TX
75495-0337
US

IV. Provider business mailing address

PO BOX 337
VAN ALSTYNE TX
75495-0337
US

V. Phone/Fax

Practice location:
  • Phone: 903-482-5279
  • Fax: 903-482-6851
Mailing address:
  • Phone: 903-482-5279
  • Fax: 903-482-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number15758
License Number StateTX

VIII. Authorized Official

Name: MR. DAVID WAYNE SCHATZ
Title or Position: OWNER-PHARMACIST
Credential: R.PH
Phone: 903-482-5279