Marie Diane Bazaldua
Pharmacist in Eagle Pass, TX. Individual provider (NPI-1).
NPI number1962744532
StatusActive
Last updated in NPPESMar 21, 2013
Details
- NPI
- 1962744532
- Entity type
- Individual (NPI-1)
- Name
- Marie Diane Bazaldua
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 21, 2013
- Last updated
- Mar 21, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 26899 | TX | Yes |
Practice location
2135 E Main StEagle Pass, TX 78852-4895
Phone 830-773-0420
Mailing address
310 Furr DrSan Antonio, TX 78201-4415
Phone 210-290-7430
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