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General NPI Number Information
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NPI Number | 1750047734
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Entity Type | Individual
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Provider Name | LEAH MARIE MARQUES
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Gender | Female
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Dates
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Enumeration Date | 11/13/2021
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Last Update Date | 11/13/2021
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Provider Practice Location Address
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Address Line | 15000 SAN PEDRO AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78232-3714
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Country | US
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Telephone | 210-494-3203
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Fax |
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Provider Business Mailing Address
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Address Line | 4214 EUTROPHIC CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78223-1802
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 326599
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License Number State | TX
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