UNIVERSITY FAMILY HEALTH CENTER SOUTHEAST PHARMACY (NPI# 1164533816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164533816 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY FAMILY HEALTH CENTER SOUTHEAST PHARMACY |
| Practice Address |
1055 Ada St San Antonio TX 78223-1703 |
| Mailing Address |
4502 Medical Dr # Ms 102-1 San Antonio TX 78229-4402 |
| Practice Telephone | 2103585534 |
| Practice Fax Number | 2103585697 |
| Mailing Telephone | 2107434022 |
| Mailing Fax Number | 2107024066 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | DR. ELLIOTT MANDELL (CPO/SVP PHARMACOTHERAPY & PHARMACY) |
| Authorized Official Telephone | 2107434022 |
| Authorized Official Credential | PHD, MBA, RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
15663 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 250387 | 05 | |
| NCPDP# (NABP#) | 4590104 | 01 |
| Street Address |
1055 ADA ST |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78223-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417947326 | Marco Xavier Garcia | Internal Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2005-10-24 |
| 1124509625 | Bridget Sedano Haggerty | Nurse Practitioner | 1055 Ada St, San Antonio, TX 78223-1703 | 2018-08-23 |
| 1821501347 | Daniel R. Flores | Pharmacist | 1055 Ada St, San Antonio, TX 78223-1703 | 2017-11-06 |
| 1740715671 | Hao Shen | Family Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2017-04-28 |
| 1639604069 | Kennedy Michael Tlaseca | Pediatrics | 1055 Ada St, San Antonio, TX 78223-1703 | 2017-04-24 |
| 1104370543 | Justine Lee Hudson | Physician Assistant | 1055 Ada St, San Antonio, TX 78223-1703 | 2016-08-13 |
| 1891149381 | Albert Bararwandika | Family Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2016-04-20 |
| 1689033722 | Stephanie Kaiser | Physician Assistant | 1055 Ada St, San Antonio, TX 78223-1703 | 2016-02-17 |
| 1477936219 | Deborah Dergan | Family Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2015-06-29 |
| 1821476649 | Kathryn Wolters | Physical Therapist | 1055 Ada St, San Antonio, TX 78223-1703 | 2015-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310344 | Celebraces Se Military Pllc | Dentist | 3611 Se Military Drive, Suite B101, San Antonio, TX 78223 | 2019-08-08 |
| 1295204410 | All Discountz Mobile Phlebotomy Services | Contractor | 6639 South New Braunfels, #19101, San Antonio, TEXAS 78223 | 2018-11-16 |
| 1588131585 | Ad Mobile Phlebotomy Services | Technician, Pathology | 6639 South New Braunfels Avenue, #19101, San Antonio, TEXAS 78223 | 2018-10-28 |
| 1437626694 | Valerie Brown | Technician, Pathology | C/o 6639 South New Braunfels Avenue, #19101, San Antonio, TEXAS 78223 | 2018-10-25 |
| 1285135574 | Allan Socrates Mamaril Angeles | Registered Nurse | 535 Hot Wells Blvd, Apt 301, San Antonio, TX 78223 | 2018-02-22 |
| 1356799845 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3502 Se Military Drive, San Antonio, TX 78223 | 2016-05-25 |
| 1467810325 | Dsi Southeast San Antonio, LLC | Clinic/Center | 2635 S.e. Military Drive, San Antonio, TX 78223 | 2016-02-08 |
| 1477832293 | Jg-surgical Assistant's,llc | Specialist/Technologist, Other | 5311 Cynthia Linn, San Antonio, TX 78223 | 2011-08-10 |
| 1841580826 | Kiddo Denal Pa | Dentist | 3520 S. New Braunfels Ste 100, Kiddo Dental, San Antonio, TX 78223 | 2011-04-12 |
| 1770885162 | Primavera Primary Home Care, Inc | Custodial Care Facility | 1007 Fair, San Antonio, TX 78223 | 2010-11-17 |
| Find all providers in zip 78223 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710502067 | West Lake Rx LLC | Pharmacy | 1255 Sw Loop 410 Ste 120, San Antonio, TX 78227-1666 | 2020-06-12 |
| 1396381224 | Texas State Pharmacy LLC | Pharmacy | 1314 E Sonterra Blvd Ste 2102, San Antonio, TX 78258-4286 | 2019-11-26 |
| 1538702956 | Zenith Rx, LLC | Pharmacy | 607 S Ww White Rd, San Antonio, TX 78220-1732 | 2019-10-18 |
| 1093366106 | Medcentrix Pharmacy, LLC | Pharmacy | 5720 Bandera Rd Ste 4b, San Antonio, TX 78238-1950 | 2019-09-20 |
| 1821648361 | Pharmacy 2 Plus LLC | Pharmacy | 9026 Culebra Rd Ste 107, San Antonio, TX 78251-2881 | 2019-09-17 |
| 1295381473 | Phyzdata Healthcare Solutions, LLC | Pharmacy | 3602 Paesanos Pkwy # 300a, San Antonio, TX 78231-1277 | 2019-08-14 |
| 1477108595 | Medcentral Pharmacy, LLC | Pharmacy | 8118 Fredericksburg Rd, San Antonio, TX 78229-3312 | 2019-08-06 |
| 1326600909 | Cvs Pharmacy Inc. | Pharmacy | 13343 Culebra Rd, San Antonio, TX 78253-6901 | 2019-07-03 |
| 1821657149 | Om Healthcare LLC | Pharmacy | 602 Bandera Rd, San Antonio, TX 78228-5203 | 2019-06-10 |
| 1831652296 | San Antonio Arthritis Care Centers Pllc | Pharmacy | 8527 Village Dr Ste 103, San Antonio, TX 78217-5507 | 2019-04-11 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78223 |
Please comment or provide details below to improve the information on UNIVERSITY FAMILY HEALTH CENTER SOUTHEAST PHARMACY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.