Provider Demographics
NPI:1699049585
Name:OPRYSHEK, JOHN HENRY (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HENRY
Last Name:OPRYSHEK
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 1:3415 FM 221
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531-3525
Mailing Address - Country:US
Mailing Address - Phone:254-386-4763
Mailing Address - Fax:
Practice Address - Street 1:3415 FM 221
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:TX
Practice Address - Zip Code:76531-3525
Practice Address - Country:US
Practice Address - Phone:254-386-4763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist