Provider Demographics
NPI:1669885356
Name:CORTINAS, LAURENCIO JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURENCIO
Middle Name:
Last Name:CORTINAS
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 1:1862 W BITTERS RD
Mailing Address - Street 2:STE 301
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1809
Mailing Address - Country:US
Mailing Address - Phone:210-832-8300
Mailing Address - Fax:210-520-1440
Practice Address - Street 1:1862 W BITTERS RD
Practice Address - Street 2:STE 301
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1809
Practice Address - Country:US
Practice Address - Phone:210-832-8300
Practice Address - Fax:210-520-1440
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX380411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist