Individual
MR. BRUCE EDWARD KOCIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
890 W CORSICANA ST, ATHENS, TX 75751-2202
(903) 675-7069
(903) 677-9459
Mailing address
890 W CORSICANA ST, ATHENS, TX 75751-2202
(903) 675-7069
(903) 677-9459
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
34493
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34493
PHARMACIST LICENSE
TX
Enumeration date
08/31/2006
Last updated
07/08/2007
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