Provider Demographics
NPI:1487788626
Name:SVOBODA, JOHN F (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:SVOBODA
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 311021
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78131-1021
Mailing Address - Country:US
Mailing Address - Phone:830-606-0526
Mailing Address - Fax:
Practice Address - Street 1:631 LAKEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4017
Practice Address - Country:US
Practice Address - Phone:830-627-0069
Practice Address - Fax:830-627-0093
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist