Ivan Jorge Juarez, PHARMD, RPH
Individual provider Active NPI Pharmacist · Pearsall, TX
NPI 1003417320 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1003417320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 50106 (TX)
- Practice address
- 819 N Oak St
Pearsall, TX 78061-3422 - Phone
- (830) 591-7934
- NPI assigned
- Nov 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50106 | TX | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores Texas LLC | Past |
Accepting new patients | |
| Wal-Mart Stores Texas, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 50106 | TX | Yes |
Addresses
Primary practice location
819 N Oak St
Pearsall, TX 78061-3422
Mailing address
522 Avenue a Apt 1302
San Antonio, TX 78215-1281
Phone (830) 591-7934
Other providers in Pearsall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.