Provider Demographics
NPI:1376945006
Name:OYANONTARUK, ARUNYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ARUNYA
Middle Name:
Last Name:OYANONTARUK
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 1:6155 ECKHERT RD APT 5307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3179
Mailing Address - Country:US
Mailing Address - Phone:770-355-2713
Mailing Address - Fax:
Practice Address - Street 1:6155 ECKHERT RD APT 5307
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3179
Practice Address - Country:US
Practice Address - Phone:770-355-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55459183500000X
NY058910183500000X
VA0202211514183500000X
GARPH026668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist