Provider Demographics
NPI:1821156530
Name:BRIGGS, JEREMY WILL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:WILL
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7219 WASHITA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2333
Mailing Address - Country:US
Mailing Address - Phone:210-875-9465
Mailing Address - Fax:
Practice Address - Street 1:2200 BERGQUIST DR. STE 1 ROOM BM 15
Practice Address - Street 2:
Practice Address - City:LACKLAND, AFB
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-292-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12879183500000X
TX44041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist