MEDICARE: RHONDA LEIGH GARY PHARMD

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	45302	TX

General Provider Information

NPI Number	:	1578891313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA LEIGH GARY PHARMD

Provider Business Mailing Address
First Line	:	3601 W WILLIAM CANNON DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1525
Country	:	US
Telephone Number	:	512-892-0930
Fax Number	:	512-892-2479

Provider Business Practice Location Address
First Line	:	3601 W WILLIAM CANNON DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1525
Country	:	US
Telephone Number	:	512-892-0930
Fax Number	:	512-892-2479

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

Provider Enumeration Date	:	12/04/2009
Last Update Date	:	12/04/2009

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