Provider Demographics
NPI:1235564295
Name:ANCHONDO, VICTOR SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:ANCHONDO
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 COSMOS AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-4025
Mailing Address - Country:US
Mailing Address - Phone:915-241-1390
Mailing Address - Fax:915-521-7706
Practice Address - Street 1:6101 GATEWAY BLVD W
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3416
Practice Address - Country:US
Practice Address - Phone:915-774-5205
Practice Address - Fax:915-774-5223
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist