Provider Demographics
NPI:1962572800
Name:LARRALDE, ANA M (R PH)
Entity type:Individual
Prefix:MR
First Name:ANA
Middle Name:M
Last Name:LARRALDE
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
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Mailing Address - Street 1:1901 SOUTH SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503
Mailing Address - Country:US
Mailing Address - Phone:956-687-6090
Mailing Address - Fax:956-687-7825
Practice Address - Street 1:1901 SOUTH SECOND STREET
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-687-6090
Practice Address - Fax:956-687-7825
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX263531835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology