Provider Demographics
NPI:1851461933
Name:FARMACIA ASSOCIATES OF SAN ANTONIO INC
Entity Type:Organization
Organization Name:FARMACIA ASSOCIATES OF SAN ANTONIO INC
Other - Org Name:GARZA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHCST
Authorized Official - Prefix:
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:210-225-4561
Mailing Address - Street 1:311 CAMDEN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-2012
Mailing Address - Country:US
Mailing Address - Phone:210-225-4561
Mailing Address - Fax:210-212-6964
Practice Address - Street 1:311 CAMDEN ST
Practice Address - Street 2:STE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2012
Practice Address - Country:US
Practice Address - Phone:210-225-4561
Practice Address - Fax:210-212-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336S0011X
TX056963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141992Medicaid
4558459OtherNCPDP PROVIDER IDENTIFICATION NUMBER