Provider Demographics
NPI:1962906735
Name:VELASQUEZ-MORALES, CLARA NOHELY (PHARMD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:NOHELY
Last Name:VELASQUEZ-MORALES
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 1:9839 KENWORTHY ST.
Mailing Address - Street 2:PHARMACY
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924
Mailing Address - Country:US
Mailing Address - Phone:915-231-2310
Mailing Address - Fax:
Practice Address - Street 1:9839 KENWORTHY ST.
Practice Address - Street 2:PHARMACY
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924
Practice Address - Country:US
Practice Address - Phone:915-231-2310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist