Individual
RYAN LAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 W WHEELER AVE, ARANSAS PASS, TX 78336-5916
(361) 758-2867
Mailing address
177 NORTHSHORE BLVD APT 5013, PORTLAND, TX 78374-1300
(956) 534-1366
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
73425
TX
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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