Provider Demographics
NPI:1740973908
Name:VILLALUZ, KARL STEPHEN (RPH)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:STEPHEN
Last Name:VILLALUZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 CIVIC CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7113
Mailing Address - Country:US
Mailing Address - Phone:312-545-3805
Mailing Address - Fax:
Practice Address - Street 1:1825 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7113
Practice Address - Country:US
Practice Address - Phone:312-545-3805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV233743336C0003X
IDP106213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy