Provider Demographics
NPI:1275665853
Name:FAVILA, PATRICIA MCHAZLETT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MCHAZLETT
Last Name:FAVILA
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 1:1435 COUNTY ROAD 2801 E
Mailing Address - Street 2:
Mailing Address - City:MICO
Mailing Address - State:TX
Mailing Address - Zip Code:78056-5549
Mailing Address - Country:US
Mailing Address - Phone:817-800-7881
Mailing Address - Fax:
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-358-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2009-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX436091835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy