Provider Demographics
NPI:1851915193
Name:SARMIENTO, GILBERT R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:R
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E PALM VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3245
Mailing Address - Country:US
Mailing Address - Phone:512-255-2144
Mailing Address - Fax:281-351-7707
Practice Address - Street 1:701 E PALM VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3245
Practice Address - Country:US
Practice Address - Phone:512-255-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX51661OtherLICENSE NUMBER