Provider Demographics
NPI:1982205258
Name:ESCAMILLA, AUGUSTINE JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTINE
Middle Name:
Last Name:ESCAMILLA
Suffix:JR
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 1:6310 GERANIUM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5863
Mailing Address - Country:US
Mailing Address - Phone:210-623-0414
Mailing Address - Fax:
Practice Address - Street 1:6703 W LOOP 1604 N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9539
Practice Address - Country:US
Practice Address - Phone:210-688-3890
Practice Address - Fax:210-688-3873
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist