Provider Demographics
NPI:1730693185
Name:TISCHLER, KELEA ANN (RPH)
Entity type:Individual
Prefix:
First Name:KELEA
Middle Name:ANN
Last Name:TISCHLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KELEA
Other - Middle Name:ANN
Other - Last Name:PELZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1201 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:GAINSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240
Mailing Address - Country:US
Mailing Address - Phone:940-668-7384
Mailing Address - Fax:940-665-8859
Practice Address - Street 1:1201 OLIVE ST.
Practice Address - Street 2:
Practice Address - City:GAINSVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240
Practice Address - Country:US
Practice Address - Phone:940-668-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist