Provider Demographics
NPI:1316796634
Name:KAHANEK, BRADEN (PHARM D)
Entity type:Individual
Prefix:
First Name:BRADEN
Middle Name:
Last Name:KAHANEK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 KESSLER AVE
Mailing Address - Street 2:
Mailing Address - City:SCHULENBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78956-1108
Mailing Address - Country:US
Mailing Address - Phone:979-743-7100
Mailing Address - Fax:
Practice Address - Street 1:104 KESSLER AVE
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956-1108
Practice Address - Country:US
Practice Address - Phone:979-743-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist