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General NPI Number Information
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NPI Number | 1861212276
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Entity Type | Individual
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Provider Name | SCOTT RANDALL MYERS PHARMD, MS
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Gender | Male
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 4502 MEDICAL DR # MS 102-1
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4492
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Country | US
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Telephone | 212-743-4034
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Fax |
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Provider Business Mailing Address
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Address Line | 10422 HUEBNER RD APT 502
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1381
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Country | US
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Telephone | 760-390-3514
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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 | 26686
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 68828
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License Number State | TX
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