Provider Demographics
NPI:1376852236
Name:NIETO, VERONICA (PHARMD)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:NIETO
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 1:1300 S COULTER ST STE 206
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1712
Mailing Address - Country:US
Mailing Address - Phone:806-356-4013
Mailing Address - Fax:806-356-4018
Practice Address - Street 1:1300 S COULTER ST STE 206
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1712
Practice Address - Country:US
Practice Address - Phone:806-356-4013
Practice Address - Fax:806-356-4018
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX487901835P1200X
KS1-150391835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy