Provider Demographics
NPI:1144819517
Name:QUIJANO, LUIS RUBEN
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:RUBEN
Last Name:QUIJANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 FM 685
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8045
Mailing Address - Country:US
Mailing Address - Phone:512-251-9037
Mailing Address - Fax:
Practice Address - Street 1:201 FM 685
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-8045
Practice Address - Country:US
Practice Address - Phone:512-251-9037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician