Provider Demographics
NPI:1518568211
Name:CRUZ, CECILIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 NW LOOP 410
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5313
Mailing Address - Country:US
Mailing Address - Phone:210-523-1123
Mailing Address - Fax:
Practice Address - Street 1:5025 NW LOOP 410
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5313
Practice Address - Country:US
Practice Address - Phone:210-523-1123
Practice Address - Fax:210-523-2707
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist