Michelle Layne Theisen

NPI #1124333109 in Universal City, Texas

Provider Information

NPI Number: 1124333109
Entity Type: Individual
Name: Michelle Layne Theisen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Aug 13, 2010
Last Updated: Aug 13, 2010

Practice Location

Address: 910 KITTYHAWK RD
City: Universal City
State: Texas
ZIP Code: 78148-3806
Phone: (210) 945-2120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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