=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750373122
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VICKI R SINGLETON RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2827 BABCOCK RD
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-4813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-705-6194
-----------------------------------------------------
Fax | 210-705-6087
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14718 KINSEM
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78248-0954
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-479-5642
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 32918
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 5122
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------