Provider Demographics
NPI:1598070948
Name:MIALKOWSKI, ANDREW RICHARD (RPH,PHARM-D)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RICHARD
Last Name:MIALKOWSKI
Suffix:
Gender:M
Credentials:RPH,PHARM-D
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:R
Other - Last Name:MIALKOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM-D
Mailing Address - Street 1:400 VALLEY HI
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-4604
Mailing Address - Country:US
Mailing Address - Phone:210-673-0741
Mailing Address - Fax:210-673-5489
Practice Address - Street 1:400 VALLEY HI
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-4604
Practice Address - Country:US
Practice Address - Phone:210-673-0741
Practice Address - Fax:210-673-5489
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist