Individual
IRVIN IVAN LEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4021 BROADWAY, SAN ANTONIO, TX 78209-6313
(210) 824-0515
Mailing address
4021 BROADWAY, SAN ANTONIO, TX 78209-6313
(210) 824-0515
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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