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General NPI Number Information
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NPI Number | 1023423738
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Entity Type | Organization
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Legal Business Name | ALAMO CITY PHARMACY LLC
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 3338 OAKWELL CT STE 106
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City | SAN ANTONIO
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State | TX
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Zip | 78218-3087
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Country | US
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Telephone | 210-268-0153
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Fax | 210-268-0162
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Provider Business Mailing Address
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Address Line | 3338 OAKWELL COURT, STE:106
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City | SAN ANTONIO
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State | TX
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Zip | 78218
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Country | US
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Telephone | 210-268-0153
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Fax | 210-268-0162
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ERNESTO F GARZA-GONGORA II
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Credential | PHARM.D.
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Telephone | 210-478-0345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 29302
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License Number State | TX
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