SUPER DRUG MART, INC. (NPI# 1447631734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447631734 |
| Entity Type | Organization |
| Organization Name | SUPER DRUG MART, INC. |
| Other Organization Name | SUPER DRUG MART |
| Practice Address |
5555 Fredericksburg Rd Suite 105 San Antonio TX 78229-3500 |
| Mailing Address |
19010 Preist Blvd Suite 101 Lytle TX 78052-3486 |
| Practice Telephone | 2104957516 |
| Practice Fax Number | 2103406998 |
| Mailing Telephone | 8307090360 |
| Mailing Fax Number | 8307090363 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |
| Authorized Official Name | MR. RAYMOND D IBANEZ SR. (OWNER/PHARMACIST) |
| Authorized Official Telephone | 8307090360 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 20307 | TX | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 144974 | 05 | |
| TX | STATE BOARD OF PHARMACY | 20307 | 01 |
| Other Name | Type Code |
|---|---|
| Super Drug Mart | Doing Business As Name - Organization |
| Street Address |
5555 FREDERICKSBURG RD SUITE 105 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78229-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407949324 | Andrea L. Zuflacht | Counselor | 5555 Fredericksburg Rd, Suite 102, San Antonio, TX 78229-3500 | 2006-10-02 |
| 1144676750 | Anna Rodriguez | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2016-05-12 |
| 1164882684 | Carolin Smith | Social Worker | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2016-02-25 |
| 1013380559 | Sheila Delgado | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2015-11-05 |
| 1073998134 | Kimberly Beck | Counselor | 5555 Fredericksburg Rd, San Antonio, TX 78229-3500 | 2015-07-29 |
| 1295130953 | Laura Blue | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2014-10-23 |
| 1386058113 | Carol Mendiola-mooers | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2014-06-19 |
| 1659702843 | Nancy Bustamante Taft | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2013-12-12 |
| 1891137196 | Margarita Gomez | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2013-07-27 |
| 1477816106 | Liliana Venegas-brown | Counselor | 5555 Fredericksburg Rd, #102, San Antonio, TX 78229-3500 | 2012-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245857226 | Lyndsey A Sandoval | Optometrist | 7400 Minton Miner St, San Antonio, TX 78229 | 2020-06-25 |
| 1295355311 | Nicolet Finger | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive, Mc 7798, San Antonio, TX 78229 | 2020-04-18 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1740822972 | Mohammad Safaie Yazdi | Student in an Organized Health Care Education/Training Program | Ut Health Science Center At San Antonio- Agdc, 8210 Floyd Curl Dr., Msc 8103, San Antonio, TX 78229 | 2019-10-09 |
| 1063053072 | Blas Edward Villa | Nurse Practitioner | 7703 Floyd Curl Drive Mc 7885 Pulmonary Diseases & Crit, Medicine, San Antonio, TX 78229 | 2019-10-01 |
| 1124673942 | Integrity Dme Services LLC | Durable Medical Equipment & Medical Supplies | 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 | 2019-08-08 |
| 1730734120 | Marisa Erin Leyden | Speech-Language Pathologist | Joe R. & Teresa Lozano Long Campus, 7703 Floyd Curl Dr., San Antonio, TX 78229 | 2019-08-03 |
| 1285295741 | Alireza Ghezavati | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive Mc 7750, Department of Pathology and Laboratory Medicine, San Antonio, TX 78229 | 2019-06-25 |
| 1407410285 | Denae Cheyenne Rushing | Student in an Organized Health Care Education/Training Program | 8201 Floyd Curl Drive, San Antonio, TX 78229 | 2019-04-26 |
| 1265993570 | Shehzad Amlani | Student in an Organized Health Care Education/Training Program | Address: 7703 Floyd Curl Dr, San Antonio, TX 78229 | 2019-03-28 |
| Find all providers in zip 78229 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003416413 | Hieu Voqui | Pharmacist | 24403 Ih 10 W, San Antonio, TX 78257-1447 | 2020-10-27 |
| 1104424704 | Joseph Samaan | Pharmacist | 602 Artisan Way, San Antonio, TX 78260-4375 | 2020-10-15 |
| 1265046874 | Raymond Gilbert Mattes Jr. | Pharmacist | 911 Cougar Country, San Antonio, TX 78251-4049 | 2020-09-01 |
| 1679186977 | Tierra Wyatt-young | Pharmacist | 4703 W Commerce St # At, San Antonio, TX 78237-1502 | 2020-08-26 |
| 1689286353 | Karla Bianca Garza | Pharmacist | 6704 Biscay Bay, San Antonio, TX 78249-2573 | 2020-08-23 |
| 1962014076 | Joseph Zavala | Pharmacist | 103 Sw Military Dr, San Antonio, TX 78221-1650 | 2020-08-19 |
| 1366054413 | Lauren Preston | Pharmacist | 3502 Se Military Dr, San Antonio, TX 78223-3486 | 2020-08-19 |
| 1154930568 | James Cory Vasquez | Pharmacist | 9900 Wurzbach Road, San Antonio, TX 78230 | 2020-07-31 |
| 1902414741 | Simplicio Aldover | Pharmacist | 901 Bitters Rd, San Antonio, TX 78216-2347 | 2020-07-17 |
| 1487279691 | Chukwuemeka Ogbu | Pharmacist | 21920 Bulverde Rd # 102-103, San Antonio, TX 78259-2181 | 2020-06-12 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78229 |
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| 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.