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General NPI Number Information
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NPI Number | 1295129971
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Entity Type | Individual
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Provider Name | JUDY MWAURA
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Gender | Female
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 8838 DUGAS DR APT 7102
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4514
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Country | US
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Telephone | 978-590-6577
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Fax |
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Provider Business Mailing Address
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Address Line | 8838 DUGAS RD APT 7102
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4514
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Country | US
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Telephone |
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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 | 54339
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License Number State | TX
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