Provider Demographics
NPI:1881922235
Name:HOLMES, STATEN JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:STATEN
Middle Name:JAMES
Last Name:HOLMES
Suffix:
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 1:9903 POTRANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-9604
Mailing Address - Country:US
Mailing Address - Phone:210-682-7431
Mailing Address - Fax:210-520-6985
Practice Address - Street 1:9903 POTRANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-9604
Practice Address - Country:US
Practice Address - Phone:210-682-7431
Practice Address - Fax:210-520-6985
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist