Provider Demographics
NPI:1215089933
Name:REEVES, BOBBY WAYNE (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:WAYNE
Last Name:REEVES
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 HAMROCK RD
Mailing Address - Street 2:
Mailing Address - City:ITALY
Mailing Address - State:TX
Mailing Address - Zip Code:76651-0636
Mailing Address - Country:US
Mailing Address - Phone:972-483-6907
Mailing Address - Fax:
Practice Address - Street 1:60 W ELM ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2036
Practice Address - Country:US
Practice Address - Phone:254-582-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist