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General NPI Number Information
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NPI Number | 1558617217
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Entity Type | Individual
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Provider Name | ROSETTE DAVILA R.PH
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Gender | Female
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 7202 SAN PEDRO AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6204
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Country | US
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Telephone | 210-340-0830
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Fax |
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Provider Business Mailing Address
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Address Line | 6411 STONYKIRK RD
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City | SAN ANTONIO
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State | TX
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Zip | 78240-3061
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Country | US
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Telephone | 210-867-0828
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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 | 30826
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License Number State | TX
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