Individual provider Active NPI

Leonel De la Garza

  • Pharmacy Technician
  • San Juan, TX
National Provider Identifier
1508457763
Registry record updated Jan 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
109443 Issued in TX
Practice address
1906 S Lincoln Ave
San Juan, TX 78589
Phone
(956) 784-1121
Fax
(956) 258-5048
NPI assigned
Jan 31, 2021
Last updated
Jan 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 109443 TX Primary

Addresses

Primary practice location

1906 S Lincoln Ave
San Juan, TX 78589

Mailing address

1906 S Lincoln Ave
San Juan, TX 78589
Phone (956) 784-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109443TXMDPharmacy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1508457763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 S LINCOLN AVE",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "78589",
            "telephone_number": "956-784-1121",
            "fax_number": "956-258-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 S LINCOLN AVE",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "78589",
            "telephone_number": "956-784-1121",
            "fax_number": "956-258-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA GARZA",
        "first_name": "LEONEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-31",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TX",
            "license": "109443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.