Provider Demographics
NPI:1568663383
Name:NAGATANI, BEATRIZ M (PHARM D)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:M
Last Name:NAGATANI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 GOLDEN WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-2215
Mailing Address - Country:US
Mailing Address - Phone:915-581-5935
Mailing Address - Fax:
Practice Address - Street 1:5401 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4909
Practice Address - Country:US
Practice Address - Phone:915-779-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA57103183500000X
TX43971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist