Provider Demographics
NPI:1477138675
Name:RAMON, ROLANDO JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:RAMON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8441 OAK THICKET
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-3646
Mailing Address - Country:US
Mailing Address - Phone:210-393-6541
Mailing Address - Fax:
Practice Address - Street 1:1 FM 3351 S STE 115
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-5729
Practice Address - Country:US
Practice Address - Phone:303-362-8828
Practice Address - Fax:830-336-2883
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist