Provider Demographics
NPI:1396300851
Name:BUERKLE, NATHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:BUERKLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S AVENUE E
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-5711
Mailing Address - Country:US
Mailing Address - Phone:940-864-2673
Mailing Address - Fax:
Practice Address - Street 1:100 S AVENUE E
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:TX
Practice Address - Zip Code:79521-5711
Practice Address - Country:US
Practice Address - Phone:940-864-2673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist