Provider Demographics
NPI:1780164962
Name:JURADO, ADRIANNA ELIZABETH (RPH)
Entity type:Individual
Prefix:DR
First Name:ADRIANNA
Middle Name:ELIZABETH
Last Name:JURADO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9610 FM 1097 RD W
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-4998
Mailing Address - Country:US
Mailing Address - Phone:936-856-4096
Mailing Address - Fax:
Practice Address - Street 1:9610 FM 1097 RD W
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77318-4998
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist