Provider Demographics
NPI:1235351701
Name:CHINO, REASOL AGUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REASOL
Middle Name:AGUSTIN
Last Name:CHINO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:REASOL
Other - Middle Name:SANTIAGO
Other - Last Name:AGUSTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9473 SOCORRO RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-6877
Mailing Address - Country:US
Mailing Address - Phone:915-858-1076
Mailing Address - Fax:915-858-2367
Practice Address - Street 1:9314 JUANCHIDO LN
Practice Address - Street 2:
Practice Address - City:YSLETA DEL SUR PUEBLO
Practice Address - State:TX
Practice Address - Zip Code:79907-6832
Practice Address - Country:US
Practice Address - Phone:301-717-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018115183500000X
MD17799183500000X
TX71008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist