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General NPI Number Information
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NPI Number | 1770208514
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Entity Type | Individual
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Provider Name | ALFONSO RAMON SOSA
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Gender | Male
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 3500 W SLAUGHTER LN
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City | AUSTIN
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State | TX
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Zip | 78749-4421
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Country | US
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Telephone | 512-292-6832
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Fax | 512-292-6865
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Provider Business Mailing Address
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Address Line | 1675 FLINT ROCK LOOP
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City | DRIFTWOOD
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State | TX
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Zip | 78619-5810
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Country | US
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Telephone | 915-203-7660
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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 | 21080
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License Number State | TX
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