Provider Demographics
NPI:1689302234
Name:VIESCA, RICARDO JR (CPHT)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:VIESCA
Suffix:JR
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3503 FREDERICKSBURG RD STE 450
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3969
Mailing Address - Country:US
Mailing Address - Phone:877-432-9355
Mailing Address - Fax:866-466-0104
Practice Address - Street 1:3503 FREDERICKSBURG RD STE 450
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3969
Practice Address - Country:US
Practice Address - Phone:877-432-9355
Practice Address - Fax:866-466-0104
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician