1841056512 NPI number — AMY FLOERKE ISAACS PHARM.D.

Table of content: AMY FLOERKE ISAACS PHARM.D. (NPI 1841056512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841056512 NPI number — AMY FLOERKE ISAACS PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ISAACS
Provider First Name:
AMY
Provider Middle Name:
FLOERKE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLOERKE
Provider Other First Name:
AMY
Provider Other Middle Name:
RENE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841056512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 HILLVIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78209-2120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-497-6170
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 HILLVIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78209-2120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-497-6170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  43307 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)