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NPI Code Detail

MEDICARE: LILY ANDREA LEDESMA

MEDICARE: LILY ANDREA LEDESMA
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
1183700000XPharmacy Technician108592TX

General Provider Information

NPI Number : 1538838826
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILY ANDREA LEDESMA
Provider Business Mailing Address
First Line : 2000 S GREGG ST
Second Line :
City : BIG SPRING
State : TX
Zip : 79720-5437
Country : US
Telephone Number : 432-263-3020
Fax Number : 432-267-7399
Provider Business Practice Location Address
First Line : 2000 S GREGG ST
Second Line :
City : BIG SPRING
State : TX
Zip : 79720-5437
Country : US
Telephone Number : 432-263-3020
Fax Number : 432-267-7399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2021
Last Update Date : 09/09/2021

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Directions to “ LILY ANDREA LEDESMA ” Practice Location

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