Provider Demographics
NPI:1386957108
Name:KLAUS, ALFRED B (RPH)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:B
Last Name:KLAUS
Suffix:
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:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-0030
Mailing Address - Country:US
Mailing Address - Phone:254-939-5738
Mailing Address - Fax:254-939-1027
Practice Address - Street 1:112 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-3279
Practice Address - Country:US
Practice Address - Phone:254-939-5738
Practice Address - Fax:254-939-1027
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist