MEDICARE: DR. VIANCA MARIE PADILLA PHARMD

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	183500000X	Pharmacist	71254	TX

General Provider Information

NPI Number	:	1831887629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIANCA MARIE PADILLA PHARMD

Provider Business Mailing Address
First Line	:	14476 HORIZON BLVD STE J
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-8579
Country	:	US
Telephone Number	:	915-852-8884
Fax Number	:

Provider Business Practice Location Address
First Line	:	14476 HORIZON BLVD STE J
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-8579
Country	:	US
Telephone Number	:	915-852-8884
Fax Number	:

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

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	04/28/2023

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