Provider Demographics
NPI:1851660005
Name:DELACRUZ, ISIDRO JOHN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ISIDRO
Middle Name:JOHN
Last Name:DELACRUZ
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 1:11023 DUBLIN BRIAR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5434
Mailing Address - Country:US
Mailing Address - Phone:210-445-8161
Mailing Address - Fax:
Practice Address - Street 1:10673 CULEBRA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1346
Practice Address - Country:US
Practice Address - Phone:210-647-9842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist