Vanessa Carrillo, PHARMD
Individual provider Active NPI Pharmacist · Eagle Pass, TX
NPI 1396054698 · NPPES record last updated Oct 4, 2010
Key facts
- NPI
- 1396054698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 49355 (TX)
- Practice address
- 2135 E Main St
Eagle Pass, TX 78852-4895 - Phone
- (830) 773-0420
- Fax
- (830) 757-5752
- NPI assigned
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49355 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H-E-B, LP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 49355 | TX | Yes |
Addresses
Primary practice location
2135 E Main St
Eagle Pass, TX 78852-4895
Mailing address
2135 E Main St
Eagle Pass, TX 78852-4895
Phone (830) 773-0420
Other providers in Eagle Pass, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2010. 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.