Provider Demographics
NPI:1528439510
Name:HERRERA, VIVIANA (PHARMD)
Entity type:Individual
Prefix:MS
First Name:VIVIANA
Middle Name:
Last Name:HERRERA
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 1:7314 NANCY LOPEZ CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1585
Mailing Address - Country:US
Mailing Address - Phone:210-661-5625
Mailing Address - Fax:
Practice Address - Street 1:107 N SUNSET STRIP ST
Practice Address - Street 2:
Practice Address - City:KENEDY
Practice Address - State:TX
Practice Address - Zip Code:78119-2208
Practice Address - Country:US
Practice Address - Phone:830-583-9155
Practice Address - Fax:830-583-9745
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist