MEDICARE: MR. ZACHARY HUNTER TYLER CPHT

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	183700000X	Pharmacy Technician	CPHT-123991	NH
2	183700000X	Pharmacy Technician	PT00009826	NM
3	183700000X	Pharmacy Technician	192165	TX

General Provider Information

NPI Number	:	1689210957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ZACHARY HUNTER TYLER CPHT

Provider Business Mailing Address
First Line	:	1301 W 38TH ST STE 403
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1013
Country	:	US
Telephone Number	:	512-956-4499
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 W 38TH ST STE 403
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1013
Country	:	US
Telephone Number	:	512-956-4499
Fax Number	:

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

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	01/04/2024

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