Provider Demographics
NPI:1528647435
Name:ARREOLA, MARY HELEN
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:HELEN
Last Name:ARREOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-4210
Mailing Address - Country:US
Mailing Address - Phone:210-232-8855
Mailing Address - Fax:
Practice Address - Street 1:430 VINCENT ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-4210
Practice Address - Country:US
Practice Address - Phone:210-232-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100483183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician