Individual
DANIELLE DEBACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 3RD ST W, UNIVERSAL CITY, TX 78150-4800
(210) 652-6403
Mailing address
221 3RD ST W, UNIVERSAL CITY, TX 78150-4800
(210) 652-6403
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
56670
TX
Other
Enumeration date
08/05/2015
Last updated
08/07/2015
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