Provider Demographics
NPI:1477070779
Name:ACOSTA, DAMARIS DELGADILLO (PHARM D)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:DELGADILLO
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12352 FM 1957
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-9273
Mailing Address - Country:US
Mailing Address - Phone:210-679-0130
Mailing Address - Fax:
Practice Address - Street 1:12352 FM 1957
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-9273
Practice Address - Country:US
Practice Address - Phone:210-679-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist