Organization
PROFESSIONAL PAVILION PHARMACY INC
Active
Other names
PROFESSIONAL PAVILION PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO MARTIN MD (OWNER)
(210) 271-7575
Entity
Organization
Contact information
Practice address
315 N SAN SABA, STE 110, SAN ANTONIO, TX 78207-3154
(210) 212-7455
(210) 212-6643
Mailing address
315 N SAN SABA, STE 110, SAN ANTONIO, TX 78207-3154
(210) 212-7455
(210) 212-6643
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
17417
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4599950
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/26/2006
Last updated
10/19/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us