MEDICARE: XAVIER SAN JORGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician

General Provider Information

NPI Number	:	1356272652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XAVIER SAN JORGE

Provider Business Mailing Address
First Line	:	24924 MORTON RANCH RD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-8146
Country	:	US
Telephone Number	:	281-574-2444
Fax Number	:	800-786-0570

Provider Business Practice Location Address
First Line	:	24924 MORTON RANCH RD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-8146
Country	:	US
Telephone Number	:	281-574-2444
Fax Number	:	800-786-0570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ XAVIER SAN JORGE ” Practice Location

Language	Start Address	Practice Location

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