Provider Demographics
NPI:1407174261
Name:LIENDO, ALVARO JESUS SR (REGISTER PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:ALVARO
Middle Name:JESUS
Last Name:LIENDO
Suffix:SR
Gender:M
Credentials:REGISTER PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W REDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3165
Mailing Address - Country:US
Mailing Address - Phone:956-722-3423
Mailing Address - Fax:956-712-3552
Practice Address - Street 1:210 W DEL MAR BLVD
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2205
Practice Address - Country:US
Practice Address - Phone:956-712-3251
Practice Address - Fax:956-712-3552
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist