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General NPI Number Information
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NPI Number | 1205819885
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Entity Type | Organization
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Legal Business Name | DAVILA PHARMACY, INC.
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 1423 GUADALUPE ST SUITE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78207-5527
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Country | US
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Telephone | 210-226-5293
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Fax | 210-224-9257
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Provider Business Mailing Address
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Address Line | 1423 GUADALUPE ST SUITE 108
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City | SAN ANTONIO
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State | TX
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Zip | 78207-5527
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Country | US
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Telephone | 210-226-5293
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Fax | 210-224-9257
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Authorized Official
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Title or Position | VICE PRESIDENT OWNER
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Name | MR. RUDY DAVILA III
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Credential | R.PH.
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Telephone | 210-226-5293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 01055
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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 | 01055
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License Number State | TX
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