Provider Demographics
NPI:1053900456
Name:PENALVER, SUZANNE ASHLEY (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:ASHLEY
Last Name:PENALVER
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 AKIN ELM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2173
Mailing Address - Country:US
Mailing Address - Phone:210-219-2315
Mailing Address - Fax:
Practice Address - Street 1:14087 OCONNOR RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1979
Practice Address - Country:US
Practice Address - Phone:210-637-0033
Practice Address - Fax:866-545-3358
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician