Provider Demographics
NPI:1295117000
Name:WYCHE, FREEMAN II
Entity type:Individual
Prefix:
First Name:FREEMAN
Middle Name:
Last Name:WYCHE
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841363
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0076
Mailing Address - Country:US
Mailing Address - Phone:281-773-4760
Mailing Address - Fax:281-997-2646
Practice Address - Street 1:837 CYPRESS CREEK PKWY
Practice Address - Street 2:SUITE 105A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3423
Practice Address - Country:US
Practice Address - Phone:281-453-7783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist