Provider Demographics
NPI:1467739995
Name:TIENDA, MARIA YVONNE (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:YVONNE
Last Name:TIENDA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 FM 78
Mailing Address - Street 2:T-2452
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1758
Mailing Address - Country:US
Mailing Address - Phone:210-424-3005
Mailing Address - Fax:210-424-3015
Practice Address - Street 1:7014 FM 78
Practice Address - Street 2:T-2452
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1758
Practice Address - Country:US
Practice Address - Phone:210-424-3005
Practice Address - Fax:210-424-3015
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist