=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619876158
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE NIKOLETTE HESS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2026
-----------------------------------------------------
Last Update Date | 11/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4821 BROADWAY
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78209-5703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-824-0515
-----------------------------------------------------
Fax | 866-461-6796
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2217 FUENTE DE GOZO
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-6582
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-824-0515
-----------------------------------------------------
Fax | 866-461-6796
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183700000X
-----------------------------------------------------
Taxonomy Name | Pharmacy Technician
-----------------------------------------------------
License Number | 362561
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------