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General NPI Number Information
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NPI Number | 1053912311
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Entity Type | Individual
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Provider Name | JOSE LORENZO CASTANEDA PUNO
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Gender | Male
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 12/23/2022
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Provider Practice Location Address
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Address Line | 4016 HIGHWAY 3
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City | DICKINSON
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State | TX
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Zip | 77539-5163
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Country | US
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Telephone | 281-337-3595
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Fax | 281-337-4759
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Provider Business Mailing Address
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Address Line | 12911 DEER SAGE CT
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City | HOUSTON
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State | TX
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Zip | 77041-6837
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Country | US
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Telephone | 832-606-6505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 67652
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 10648
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License Number State | TX
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