Provider Demographics
NPI:1568040905
Name:VIESCA, ALBERT (PHARMACY STUDENT)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:VIESCA
Suffix:
Gender:M
Credentials:PHARMACY STUDENT
Other - Prefix:
Other - First Name:ALBERT
Other - Middle Name:
Other - Last Name:VIESCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NONE
Mailing Address - Street 1:23814 TUMBLEWEED LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78264-9237
Mailing Address - Country:US
Mailing Address - Phone:210-853-8144
Mailing Address - Fax:
Practice Address - Street 1:23814 TUMBLEWEED LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78264-9237
Practice Address - Country:US
Practice Address - Phone:210-853-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program