Provider Demographics
NPI:1922556331
Name:CORTEZ, JEFFERY MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:MICHAEL
Last Name:CORTEZ
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:CMR 411 BOX 3373
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-0034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 SUDLAGER
Practice Address - Street 2:USAMEDDAC-BAVARIA
Practice Address - City:VILSECK
Practice Address - State:BAVARIA
Practice Address - Zip Code:92249
Practice Address - Country:DE
Practice Address - Phone:314-590-3509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist