Provider Demographics
NPI:1407845977
Name:PERSYN, ANGELA D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:D
Last Name:PERSYN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6601 BLANCO RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6105
Mailing Address - Country:US
Mailing Address - Phone:210-510-2692
Mailing Address - Fax:210-736-4438
Practice Address - Street 1:6601 BLANCO RD STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6105
Practice Address - Country:US
Practice Address - Phone:210-510-2692
Practice Address - Fax:210-736-4438
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist