Provider Demographics
NPI:1487818274
Name:LAT, ASMABANU (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASMABANU
Middle Name:
Last Name:LAT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ASMA
Other - Middle Name:
Other - Last Name:LAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7400 MERTON MINTER ST
Mailing Address - Street 2:PHARMACY (119)
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:214-228-8452
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:PHARMACY (119)
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:214-228-8452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist