Provider Demographics
NPI:1194855932
Name:NUNEZ, DAVID HUMBERTO (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HUMBERTO
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W ZIA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6910
Mailing Address - Country:US
Mailing Address - Phone:505-670-0217
Mailing Address - Fax:
Practice Address - Street 1:525 W ZIA RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6910
Practice Address - Country:US
Practice Address - Phone:505-829-2196
Practice Address - Fax:505-820-2219
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist