Provider Demographics
NPI:1396314571
Name:MICHAELS, JESSICA ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:MICHAELS
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 1:3503 FREDERICKSBURG RD STE 450
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3969
Mailing Address - Country:US
Mailing Address - Phone:877-432-9355
Mailing Address - Fax:866-466-0104
Practice Address - Street 1:3503 FREDERICKSBURG RD STE 450
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3969
Practice Address - Country:US
Practice Address - Phone:877-432-9355
Practice Address - Fax:866-466-0104
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist