Provider Demographics
NPI:1194169151
Name:PATALIK, EUGENE FRANK JR (RPH)
Entity type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:FRANK
Last Name:PATALIK
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6929 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3629
Mailing Address - Country:US
Mailing Address - Phone:512-421-1000
Mailing Address - Fax:512-421-1005
Practice Address - Street 1:6929 AIRPORT BLVD SUITE 176
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-6929
Practice Address - Country:US
Practice Address - Phone:512-577-0220
Practice Address - Fax:512-421-1005
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist