Individual
ALEECIAGENE CARLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4821 BROADWAY, SAN ANTONIO, TX 78209-5703
(210) 824-0515
Mailing address
4821 BROADWAY, SAN ANTONIO, TX 78209-5703
(210) 824-0515
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
309960
TX
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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