Organization
PROVIDERX OF SAN ANTONIO, LLC
Active
Other names
PROVIDERX OF SAN ANTONIO
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY ALLARD (GENERAL MANAGER)
(817) 778-4181
Entity
Organization
Contact information
Practice address
11335 WEST AVE, SAN ANTONIO, TX 78213-1341
(210) 399-3570
(866) 335-0964
Mailing address
11335 WEST AVE, SAN ANTONIO, TX 78213-1341
(210) 399-3570
(866) 335-0964
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4537900
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/25/2006
Last updated
05/17/2010
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