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NPI Code Detail

MEDICARE: JUDY L TOBIN

MEDICARE: JUDY L TOBIN
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
1183500000XPharmacist43969TX

General Provider Information

NPI Number : 1609105725
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY L TOBIN
Provider Business Mailing Address
First Line : 4501 GUADALUPE ST
Second Line :
City : AUSTIN
State : TX
Zip : 78751-2937
Country : US
Telephone Number : 512-323-6098
Fax Number :
Provider Business Practice Location Address
First Line : 4501 GUADALUPE ST
Second Line :
City : AUSTIN
State : TX
Zip : 78751-2937
Country : US
Telephone Number : 512-323-6098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2009
Last Update Date : 12/19/2009

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Directions to “ JUDY L TOBIN ” Practice Location

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