MEDICARE: DR. LAUREN SOKOL CORRALES PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	59151	TX

General Provider Information

NPI Number	:	1679108146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN SOKOL CORRALES PHARMD

Provider Business Mailing Address
First Line	:	3410 ROOSEVELT AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78214-2606
Country	:	US
Telephone Number	:	210-922-9031
Fax Number	:	210-927-5577

Provider Business Practice Location Address
First Line	:	119 HUIZAR ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78214-2707
Country	:	US
Telephone Number	:	210-922-9031
Fax Number	:	210-927-5577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	04/05/2021

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