Individual
AZUH NDIKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
12835 POTRANCO RD, SAN ANTONIO, TX 78253-6772
(210) 679-0250
Mailing address
1414 PITCHER BND, SAN ANTONIO, TX 78253-4235
(240) 706-0643
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
61384
TX
Other
Enumeration date
04/17/2012
Last updated
01/07/2024
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