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Individual

MR. EDELMIRO TELLEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2515 CASTROVILLE RD, SAN ANTONIO, TX 78237-3359
(210) 432-2361
Mailing address
2515 CASTROVILLE RD, SAN ANTONIO, TX 78237-3359
(210) 432-2361

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
TX
3336C0003X
Community/Retail Pharmacy
Primary
TX
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy
TX
3336M0003X
Managed Care Organization Pharmacy
TX

Other

Enumeration date
03/24/2021
Last updated
03/24/2021
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