Provider Demographics
NPI:1144515222
Name:KONOPKA, JIM (RPH)
Entity type:Individual
Prefix:
First Name:JIM
Middle Name:
Last Name:KONOPKA
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 1:18700 LIMESTONE COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-6544
Mailing Address - Country:US
Mailing Address - Phone:512-687-2065
Mailing Address - Fax:
Practice Address - Street 1:18700 LIMESTONE COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-6544
Practice Address - Country:US
Practice Address - Phone:512-687-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist