Provider Demographics
NPI:1700200052
Name:GARCIA, MELINDA SUE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:SUE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 BABCOCK RD
Mailing Address - Street 2:STE 540
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6028
Mailing Address - Country:US
Mailing Address - Phone:210-614-7865
Mailing Address - Fax:
Practice Address - Street 1:2829 BABCOCK RD
Practice Address - Street 2:STE 540
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6028
Practice Address - Country:US
Practice Address - Phone:210-614-7865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist