Provider Demographics
NPI:1093588113
Name:RIOS, DAPHNE NICOLE
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:NICOLE
Last Name:RIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12125 ALAMO RANCH PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4334
Mailing Address - Country:US
Mailing Address - Phone:210-688-9584
Mailing Address - Fax:
Practice Address - Street 1:12125 ALAMO RANCH PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4334
Practice Address - Country:US
Practice Address - Phone:210-688-9584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223120183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician