Provider Demographics
NPI:1811318900
Name:NAVARRETE, JACQUELYN PADILLA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:PADILLA
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 GEORGE DIETER DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3855
Mailing Address - Country:US
Mailing Address - Phone:915-255-4758
Mailing Address - Fax:
Practice Address - Street 1:1901 GEORGE DIETER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-3855
Practice Address - Country:US
Practice Address - Phone:915-255-4758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist