Basic Information
| Provider Information | |||||||||
| NPI: | 1962572800 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LARRALDE | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R. PH. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 SOUTH SECOND STREET | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566876090 | ||||||||
| FaxNumber: | 9566877825 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 SOUTH SECOND STREET | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566876090 | ||||||||
| FaxNumber: | 9566877825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835X0200X | 26353 | TX | Y | Pharmacy Service Providers | Pharmacist | Oncology |
No ID Information.