Provider Demographics
NPI:1699089045
Name:SCHWARTZ, CHARLES CHRISTOPHER (RPH)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:CHRISTOPHER
Last Name:SCHWARTZ
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 1:112 TRAILCREST ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1319
Mailing Address - Country:US
Mailing Address - Phone:210-494-6600
Mailing Address - Fax:
Practice Address - Street 1:112 TRAILCREST ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1319
Practice Address - Country:US
Practice Address - Phone:210-494-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21836OtherTEXAS STATE BOARD OF PHARMACY LICENSE NUMBER