Provider Demographics
NPI:1831476712
Name:AJUZIE, STEPHEN N (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:N
Last Name:AJUZIE
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 1:410 W CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4601
Mailing Address - Country:US
Mailing Address - Phone:210-225-4809
Mailing Address - Fax:210-225-2169
Practice Address - Street 1:410 W CYPRESS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4601
Practice Address - Country:US
Practice Address - Phone:210-225-4809
Practice Address - Fax:210-225-2169
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35004183500000X
GARPH020067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist