Provider Demographics
NPI:1699350348
Name:RUFFNER, PAUL DAVID (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:RUFFNER
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 1:1569 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-3815
Mailing Address - Country:US
Mailing Address - Phone:936-295-6448
Mailing Address - Fax:936-291-8012
Practice Address - Street 1:1569 11TH ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3815
Practice Address - Country:US
Practice Address - Phone:936-295-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist