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Individual

CAROL JEAN DE DIOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
1500 SAN MIGUEL CT, MIDLAND, TX 79705-2225
(661) 204-7305
Mailing address
1500 SAN MIGUEL CT, MIDLAND, TX 79705-2225
(661) 204-7305

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
43891
CA
183500000X
Pharmacist
Primary
8405
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8405
OR
Enumeration date
07/10/2019
Last updated
07/10/2019
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