Provider Demographics
NPI:1053756031
Name:PADRON, DAVID BRANDON (PHARMD RPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRANDON
Last Name:PADRON
Suffix:
Gender:M
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 HUEBNER OAKS
Mailing Address - Street 2:#1416
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1179
Mailing Address - Country:US
Mailing Address - Phone:361-935-0242
Mailing Address - Fax:
Practice Address - Street 1:721 CASTROVILLE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3134
Practice Address - Country:US
Practice Address - Phone:210-436-6465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist