MEDICARE: MICHAEL MUECKE RPH

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	21383	TX

General Provider Information

NPI Number	:	1225107907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MUECKE RPH

Provider Business Mailing Address
First Line	:	2808 7TH ST
Second Line	:
City	:	BAY CITY
State	:	TX
Zip	:	77414-5306
Country	:	US
Telephone Number	:	979-244-1772
Fax Number	:	979-244-1498

Provider Business Practice Location Address
First Line	:	2808 7TH ST
Second Line	:
City	:	BAY CITY
State	:	TX
Zip	:	77414-5306
Country	:	US
Telephone Number	:	979-244-1772
Fax Number	:	979-244-1498

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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