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General NPI Number Information
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NPI Number | 1821459462
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Entity Type | Individual
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Provider Name | JAGDISH BHAKTA RPH
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Gender | Male
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Dates
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Enumeration Date | 03/10/2016
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Last Update Date | 03/10/2016
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Provider Practice Location Address
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Address Line | 502 NEW VALLEY HI DR
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City | SAN ANTONIO
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State | TX
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Zip | 78227-4394
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Country | US
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Telephone | 210-673-0817
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Fax |
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Provider Business Mailing Address
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Address Line | 6051 VALPARAISO WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4870
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Country | US
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Telephone | 210-468-5444
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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 | 1-12951
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 39305
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License Number State | TX
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