Provider Demographics
NPI:1467811398
Name:DAVID, TERESA CADIZ (RPH)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:CADIZ
Last Name:DAVID
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 1:8618 PALMER LN
Mailing Address - Street 2:
Mailing Address - City:PONDER
Mailing Address - State:TX
Mailing Address - Zip Code:76259-5618
Mailing Address - Country:US
Mailing Address - Phone:858-209-8774
Mailing Address - Fax:
Practice Address - Street 1:609 MEDICAL CENTER DR STE 1100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3840
Practice Address - Country:US
Practice Address - Phone:940-626-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-20
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist