MEDICARE: HARRIETT ARLENE WAHLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18693	TX

General Provider Information

NPI Number	:	1013056142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRIETT ARLENE WAHLER

Provider Business Mailing Address
First Line	:	8016 HERNDON DR
Second Line	:
City	:	BENBROOK
State	:	TX
Zip	:	76116-8537
Country	:	US
Telephone Number	:	817-244-5520
Fax Number	:	817-737-5018

Provider Business Practice Location Address
First Line	:	5932 LOVELL AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-5030
Country	:	US
Telephone Number	:	917-737-6655
Fax Number	:	817-737-5018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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Directions to “ HARRIETT ARLENE WAHLER ” Practice Location

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