Provider Demographics
NPI:1760355465
Name:ACOSTA, JULIO
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-1951
Mailing Address - Country:US
Mailing Address - Phone:325-690-5011
Mailing Address - Fax:866-573-9425
Practice Address - Street 1:1345 BARROW ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-5171
Practice Address - Country:US
Practice Address - Phone:325-690-5011
Practice Address - Fax:866-573-9425
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX355366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist