Provider Demographics
NPI:1942830120
Name:ORNELAS, ALESSANDRIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALESSANDRIA
Middle Name:
Last Name:ORNELAS
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 1:234 ORANGE MIMOSA LN
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3829
Mailing Address - Country:US
Mailing Address - Phone:915-217-3690
Mailing Address - Fax:
Practice Address - Street 1:234 ORANGE MIMOSA LN
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3829
Practice Address - Country:US
Practice Address - Phone:915-217-3690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist