Provider Demographics
NPI:1760751838
Name:FALCO, JUANITA R (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:R
Last Name:FALCO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 TOEPPERWEIN RD
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109
Mailing Address - Country:US
Mailing Address - Phone:210-659-8177
Mailing Address - Fax:
Practice Address - Street 1:10650 TOEPPERWEIN RD
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2476
Practice Address - Country:US
Practice Address - Phone:210-659-8177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49876183500000X
NJ28RI03408900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist