Provider Demographics
NPI:1316277650
Name:CONTRERAS, CIPRIANO CASAS JR (BS, RPH)
Entity type:Individual
Prefix:MR
First Name:CIPRIANO
Middle Name:CASAS
Last Name:CONTRERAS
Suffix:JR
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 NOGALITOS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78225-1750
Mailing Address - Country:US
Mailing Address - Phone:210-533-0704
Mailing Address - Fax:
Practice Address - Street 1:2710 NOGALITOS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78225-1750
Practice Address - Country:US
Practice Address - Phone:210-533-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist