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General NPI Number Information
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NPI Number | 1386994168
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Entity Type | Individual
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Provider Name | IVETTE Y TALAVERA PHARMD.
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Gender | Female
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 191 W LOOP 1604 S
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City | SAN ANTONIO
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State | TX
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Zip | 78245-4191
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Country | US
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Telephone | 210-868-6735
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Fax | 210-868-6726
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Provider Business Mailing Address
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Address Line | 191 W LOOP 1604 S
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City | SAN ANTONIO
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State | TX
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Zip | 78245-4191
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Country | US
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Telephone | 210-868-6735
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Fax | 210-868-6726
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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 | 45457
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License Number State | TX
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