Provider Demographics
NPI:1538487301
Name:SAENZ, ELEUTERIO LOPEZ
Entity Type:Individual
Prefix:
First Name:ELEUTERIO
Middle Name:LOPEZ
Last Name:SAENZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E KLEBERG AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-3804
Mailing Address - Country:US
Mailing Address - Phone:361-595-0361
Mailing Address - Fax:361-595-1449
Practice Address - Street 1:409 E KLEBERG AVE
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-3804
Practice Address - Country:US
Practice Address - Phone:361-595-0361
Practice Address - Fax:361-595-1449
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist