Doctor Name: | MR. JASON WAYNE KONEMAN |
NPI Number: | 1730412396 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CPHT |
License Number: | 260101030750018 |
Business Practice Address: | 2615 Meadow Ln La Marque, TX - 775685043 |
Business Phone Number: | 4093569059 |
Business Fax Number: | 4093569057 |
Mailing Address: | Po Box 1635, LA MARQUE |
State: | TX |
Postal Code: | 775681635 |
Phone Number: | 4093569059 |
Fax Number: | 4093569057 |
NPI Enumeration Date: | 09/15/2009 |
NPI Last Update Date: | 05/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | 260101030750018 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |