Individual
BRIAN J. TAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 553-4365
Mailing address
5016 WATERCREST RD APT 7203, KILLEEN, TX 76549-6375
(407) 721-3929
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
20549
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41051775
DRIVER LICENSE
TX
Enumeration date
05/04/2018
Last updated
05/04/2018
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