Provider Demographics
NPI:1821321316
Name:DURON, RAUDEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAUDEL
Middle Name:
Last Name:DURON
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 1:901 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-4269
Mailing Address - Country:US
Mailing Address - Phone:575-835-9495
Mailing Address - Fax:575-838-4916
Practice Address - Street 1:901 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-4269
Practice Address - Country:US
Practice Address - Phone:575-835-9495
Practice Address - Fax:575-838-4916
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist