Provider Demographics
NPI:1568709863
Name:CERECERES, RAMON JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:CERECERES
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-3803
Mailing Address - Country:US
Mailing Address - Phone:210-432-7334
Mailing Address - Fax:210-432-8179
Practice Address - Street 1:1630 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-3803
Practice Address - Country:US
Practice Address - Phone:210-432-7334
Practice Address - Fax:210-432-8179
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist