Provider Demographics
NPI:1952688533
Name:QUIJAS, LAURA MELISSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MELISSA
Last Name:QUIJAS
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 1:4900 ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2802
Mailing Address - Country:US
Mailing Address - Phone:915-772-5331
Mailing Address - Fax:915-772-9830
Practice Address - Street 1:4900 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2802
Practice Address - Country:US
Practice Address - Phone:915-772-5331
Practice Address - Fax:915-772-9830
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX43482OtherTEXAS STATE BOARD OF PHARMACY