Provider Demographics
NPI:1356603518
Name:APACIBLE, ROXANA MYRA (PHARMD)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:MYRA
Last Name:APACIBLE
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 1:3550 S GENERAL BRUCE DR
Mailing Address - Street 2:T-2278
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-5138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3550 S GENERAL BRUCE DR
Practice Address - Street 2:T-2278
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5138
Practice Address - Country:US
Practice Address - Phone:254-295-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist