Provider Demographics
NPI:1154193001
Name:DURAN, BIANCA ALEXIS (PHARMD)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:ALEXIS
Last Name:DURAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 CAPELLO WAY
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-3810
Mailing Address - Country:US
Mailing Address - Phone:915-245-1174
Mailing Address - Fax:
Practice Address - Street 1:3401 JOE BATTLE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-2791
Practice Address - Country:US
Practice Address - Phone:915-849-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist