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General NPI Number Information
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NPI Number | 1336366814
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Entity Type | Individual
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Provider Name | JOHNNY JAY SPLAWN R.PH
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BUILDING 3600 3851 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-6200
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Country | US
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Telephone | 210-916-2446
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 DWYERBROOK
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City | SAN ANTONIO
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State | TX
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Zip | 78253
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Country | US
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Telephone | 210-679-8869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25945
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License Number State | TX
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