Organization
FIDEL G. HUERTA JR., INC.
Active
Other names
Health Professionals
Organization subpart
No
Provider details
NPI number
Authorized official
FIDEL G HUERTA RPH (OWNER PRESIDENT)
(210) 433-9991
Entity
Organization
Contact information
Practice address
2115 PLEASANTON RD, SUITE 100, SAN ANTONIO, TX 78221-1321
(210) 923-7717
(210) 923-3720
Mailing address
2115 PLEASANTON RD., SUITE 100, SA ANTONIO, TX 78221
(210) 923-7717
(210) 923-3720
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
16707
TX
3336C0003X
Community/Retail Pharmacy
Primary
16707
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144301
—
TX
01
—
4595166
NCPDP OR NABP
TX
Enumeration date
02/20/2007
Last updated
12/15/2008
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