Individual
SIMON SHAJU KAROTTAKUTTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(210) 617-5300
Mailing address
8826 BREANNA OAKS, SAN ANTONIO, TX 78254-6269
(210) 522-9651
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
10085890
TX
Other
Enumeration date
06/01/2017
Last updated
05/29/2019
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