Provider Demographics
NPI:1952462046
Name:LARBIE, DEREK JOSHUA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:JOSHUA
Last Name:LARBIE
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 1:24302 WOODROSE PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2243
Mailing Address - Country:US
Mailing Address - Phone:210-257-9119
Mailing Address - Fax:210-292-2719
Practice Address - Street 1:59TH MEDICAL WING
Practice Address - Street 2:
Practice Address - City:LACKLAND AIR FORCE BASE
Practice Address - State:TX
Practice Address - Zip Code:78236-5300
Practice Address - Country:US
Practice Address - Phone:210-292-5478
Practice Address - Fax:210-292-5419
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist