Provider Demographics
NPI:1821874819
Name:ROLLOQUE, JOYCE-ABIGAIL SALVADOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOYCE-ABIGAIL
Middle Name:SALVADOR
Last Name:ROLLOQUE
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 1:5205 AUBURN ST APT 133
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-1614
Mailing Address - Country:US
Mailing Address - Phone:210-393-8287
Mailing Address - Fax:
Practice Address - Street 1:3402 SLIDE RD
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-2542
Practice Address - Country:US
Practice Address - Phone:806-797-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist