MEDICARE: MARENA DEL SOL ORTIZ MORALES PHARMACY TECNICIAN

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	10508	PR
2	183700000X	Pharmacy Technician	279704	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	279704	OTHER	TX	PHARMACY TECHNICIAN LICENSE
2	10508	OTHER	PR	PHARMACY TECNICIAN LICENSE
3	1177941	OTHER	TX	NABP
4	30066793	OTHER	TX	CPHT CETIFICATE
5	1396106043	OTHER	TX	NPI

General Provider Information

NPI Number	:	1396106043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARENA DEL SOL ORTIZ MORALES PHARMACY TECNICIAN

Provider Business Mailing Address
First Line	:	7450 N SHEPHERD DR APT 1308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-2468
Country	:	US
Telephone Number	:	787-627-1241
Fax Number	:

Provider Business Practice Location Address
First Line	:	7450 N SHEPHERD DR APT 1308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-2468
Country	:	US
Telephone Number	:	787-627-1241
Fax Number	:

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

Provider Enumeration Date	:	03/09/2016
Last Update Date	:	03/21/2018

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