DR. LUIS OMAR VALDIVIESO JR. (NPI# 1881762300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881762300 |
Entity Type | Individual |
Full Name | DR. LUIS OMAR VALDIVIESO JR. |
Credential | PHARM.D. |
Practice Address |
2100 Berqguire Rd Ste No. 1 San Antonio TX 78236 |
Mailing Address |
13116 Mystic Saddle Helotes TX 78023-3985 |
Practice Telephone | 2102922453 |
Enumeration Date | 2006-12-01 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835N1003X |
Pharmacist Specialization: Nutrition Support |
42791 | TX | Pharmacy Service Providers |
Street Address |
2100 BERQGUIRE RD STE NO. 1 |
City | SAN ANTONIO |
State | TX |
Zip Code | 78236 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
Find all providers in zip 78236 |
Taxonomy Code | 1835N1003X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Nutrition Support |
A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |
Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316039894 | Renee Anne Bellanger | Pharmacist | 4301 Broadway, Cpo 99, San Antonio, TX 78209 | 2006-09-29 |
1568560126 | George Melnik | Pharmacist | 7400 Merton Minter St, San Antonio, TX 78229-4404 | 2006-09-20 |
1093792665 | Vernon Theodore Lew | Pharmacist | 2200 Bergquist Dr, Bldg 8410, San Antonio, TX 78236-9907 | 2005-12-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720543754 | Donna Bellia | Pharmacist | 211 E Creekview Dr, Fredericksburg, TX 78624-5434 | 2019-02-04 |
1457844656 | Jean Ann Graham | Pharmacist | 2503 Saratoga Dr, Austin, TX 78733-1240 | 2018-06-12 |
1295274397 | People's Wellness Center | Pharmacist | 13860 N Us Highway 183 Ste C, Austin, TX 78750-1203 | 2017-02-22 |
1881080109 | Patrece Jones | Pharmacist | 18101 Point Lookout Dr, 343, Houston, TX 77058-3569 | 2015-04-14 |
1659771194 | Rick Ferris | Pharmacist | 115 Tower Rd, Valley View, TX 76272-7668 | 2014-09-03 |
1447509625 | Barbara Ann Campbell | Pharmacist | 13860 Highway 183 North Suite C, Austin, TX 78750 | 2012-09-05 |
1457616708 | David Christian Morcom | Pharmacist | 16306 Shadybank Dr, Dallas, TX 75248-2957 | 2012-07-11 |
1881806321 | Todd Wayne Canada | Pharmacist | 1515 Holcombe Boulevard, Unit 377, Division of Pharmacy, Houston, TX 77030-4009 | 2007-05-04 |
1720129851 | E. J. Stein | Pharmacist | 2004 W State Highway 29, Burnet, TX 78611-2353 | 2007-02-10 |
1730237025 | Elizabeth Rose Kaczmarek | Pharmacist | 108 Arabian Dr, Victoria, TX 77904-3248 | 2007-01-05 |
Find all providers with the same taxonomy |
City | SAN ANTONIO |
Zip Code | 78236 |
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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.