Provider Demographics
NPI:1235467549
Name:MONTEMAYOR, MARYBEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARYBEL
Middle Name:
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 680066
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78268-0066
Mailing Address - Country:US
Mailing Address - Phone:325-212-4199
Mailing Address - Fax:
Practice Address - Street 1:19203 STONE OAK PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3254
Practice Address - Country:US
Practice Address - Phone:210-403-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist