Provider Demographics
NPI:1619601713
Name:CARVER, MARIA D
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:CARVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6204
Mailing Address - Country:US
Mailing Address - Phone:210-340-0830
Mailing Address - Fax:210-340-8761
Practice Address - Street 1:7202 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6204
Practice Address - Country:US
Practice Address - Phone:210-340-0830
Practice Address - Fax:210-340-8761
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist