Provider Demographics
NPI:1750036208
Name:BRIONES, JOSE SANTOS (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:SANTOS
Last Name:BRIONES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 GREENWAY DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-3145
Mailing Address - Country:US
Mailing Address - Phone:361-765-3114
Mailing Address - Fax:
Practice Address - Street 1:102 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-4350
Practice Address - Country:US
Practice Address - Phone:361-355-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty