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General NPI Number Information
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NPI Number | 1598089534
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Entity Type | Individual
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Provider Name | CAROL TATE PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 11210 POTRANCO RD
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City | SAN ANTONIO
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State | TX
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Zip | 78253-5844
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Country | US
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Telephone | 210-679-9208
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Fax | 210-679-9228
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Provider Business Mailing Address
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Address Line | 15425 CHINQUAPIN
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City | HELOTES
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State | TX
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Zip | 78023-5122
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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 | 41714
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License Number State | TX
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