Individual
TRAVIS JORDAN GROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9900 WURZBACH RD, SAN ANTONIO, TX 78230-2212
(210) 696-1077
(210) 699-8760
Mailing address
9900 WURZBACH RD, SAN ANTONIO, TX 78230-2212
(210) 696-1077
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
244273
TX
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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