Provider Demographics
NPI:1114252657
Name:WOODLEY, LUCIA AMPARO (RPH)
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:AMPARO
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 LOS ARBOLES DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-0913
Mailing Address - Country:US
Mailing Address - Phone:575-915-5951
Mailing Address - Fax:
Practice Address - Street 1:9484 DYER ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-6411
Practice Address - Country:US
Practice Address - Phone:915-757-2531
Practice Address - Fax:915-751-3760
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35595183500000X
NMRP6852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist