Provider Demographics
NPI:1730502915
Name:JOHN, JOBBY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOBBY
Middle Name:
Last Name:JOHN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 BEE CAVE RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738
Mailing Address - Country:US
Mailing Address - Phone:512-608-9355
Mailing Address - Fax:512-608-9265
Practice Address - Street 1:12005 BEE CAVE RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738
Practice Address - Country:US
Practice Address - Phone:512-608-9355
Practice Address - Fax:512-608-9265
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX534041835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist