Provider Demographics
NPI:1104430743
Name:IBARGUEN, JEFFREY GARCES (PHARMD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:GARCES
Last Name:IBARGUEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6322 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-5410
Mailing Address - Country:US
Mailing Address - Phone:713-644-1815
Mailing Address - Fax:713-644-9698
Practice Address - Street 1:6322 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-5410
Practice Address - Country:US
Practice Address - Phone:713-644-1815
Practice Address - Fax:713-644-9698
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist