Provider Demographics
NPI:1538469077
Name:TAMU-CC HEALTHCENTER PHARMACY
Entity Type:Organization
Organization Name:TAMU-CC HEALTHCENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIGIO
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAENZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:361-825-6079
Mailing Address - Street 1:6300 OCEAN DR
Mailing Address - Street 2:UNIT 5715
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-5715
Mailing Address - Country:US
Mailing Address - Phone:361-825-6079
Mailing Address - Fax:
Practice Address - Street 1:6300 OCEAN DR
Practice Address - Street 2:UNIT 5715
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-5715
Practice Address - Country:US
Practice Address - Phone:361-825-6079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21380333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy