Lucero Villa
Individual provider Active NPI Pharmacist · Daingerfield, TX
NPI 1497357347 · NPPES record last updated Nov 14, 2020
Key facts
- NPI
- 1497357347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 67603 (TX)
- Practice address
- 609 Linda Dr
Daingerfield, TX 75638-2115 - Phone
- (903) 645-4552
- NPI assigned
- Nov 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67603 | TX | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 67603 | TX | Yes |
Addresses
Primary practice location
609 Linda Dr
Daingerfield, TX 75638-2115
Mailing address
156 Private Road 4742
Mount Pleasant, TX 75455-1084
Phone (903) 563-0072
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841363314 | Other | RETAIL PHARMACY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Brookshires |
Other providers in Daingerfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 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.