Provider Demographics
NPI:1184994436
Name:OLMEDA, VERENICE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VERENICE
Middle Name:
Last Name:OLMEDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:VERENICE
Other - Middle Name:
Other - Last Name:OLMEDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACY DOCTOR
Mailing Address - Street 1:1418 E UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3710
Mailing Address - Country:US
Mailing Address - Phone:956-380-6551
Mailing Address - Fax:
Practice Address - Street 1:1418 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3710
Practice Address - Country:US
Practice Address - Phone:956-380-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist