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General NPI Number Information
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NPI Number | 1871472233
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Entity Type | Individual
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Provider Name | MAYA BERDEJA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 11521 N FM 620 RD STE A
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City | AUSTIN
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State | TX
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Zip | 78726-1168
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Country | US
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Telephone | 512-249-0577
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Fax |
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Provider Business Mailing Address
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Address Line | 11521 N FM 620 RD STE A
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City | AUSTIN
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State | TX
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Zip | 78726-1168
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Country | US
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Telephone | 512-249-0577
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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 | 346749
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License Number State | TX
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