Provider Demographics
NPI:1164009122
Name:NARVAEZ, MARISSA ALAMAR
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:ALAMAR
Last Name:NARVAEZ
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 1:5470 W MILITARY DR APT 2301
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78242-1259
Mailing Address - Country:US
Mailing Address - Phone:210-771-1169
Mailing Address - Fax:
Practice Address - Street 1:5470 W MILITARY DR APT 2301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78242-1259
Practice Address - Country:US
Practice Address - Phone:210-771-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291633183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician