Providerx of San Antonio, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

PROVIDERX OF SAN ANTONIO, LLC

Doing business as

PROVIDERX OF SAN ANTONIO

Practice address

11335 West Ave
San Antonio, TX 78213-1341

Phone

(210) 399-3570

Fax

(866) 335-0964

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Terry Allard

Title

General Manager

Phone

(817) 778-4181

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PROVIDERX OF SAN ANTONIO Doing business as

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1760582068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11335 WEST AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131341",
            "telephone_number": "210-399-3570",
            "fax_number": "866-335-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 WEST AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131341",
            "telephone_number": "210-399-3570",
            "fax_number": "866-335-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDERX OF SAN ANTONIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "ALLARD",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "817-778-4181"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4537900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDERX OF SAN ANTONIO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Proud, M.D.
• Charles Allen Proulx, PA-C
• Steven E Prouty
• Ellyse Nicole Provencio
• Provider Care at Home LLC
• Alejandro Pruitt, MD
• Andrea Alicia Pruitt, R.N.
• Tabitha Vivens Pruitt
• Augustin C Pruneda Jr., OD
• Marilidia Aslan Pruneda

• Long Term Care Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Long Term Care Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.