1083648729 NPI number — DR. KRISTOPHER JOHN ZEPEDA PHARM D

Table of content: DR. KRISTOPHER JOHN ZEPEDA PHARM D (NPI 1083648729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083648729 NPI number — DR. KRISTOPHER JOHN ZEPEDA PHARM D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEPEDA
Provider First Name:
KRISTOPHER
Provider Middle Name:
JOHN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083648729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5802 92ND
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-441-9608
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
805 TAHOKA ROAD
Provider Second Line Business Practice Location Address:
NELSON PHARMACY
Provider Business Practice Location Address City Name:
BROWNFIELD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-637-3533
Provider Business Practice Location Address Fax Number:
806-637-4212
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  42377 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com