Provider Demographics
NPI:1447963988
Name:HERRERA, JESSICA ROCHELLE (RPH)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ROCHELLE
Last Name:HERRERA
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 1:23530 WILDERNESS OAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2406
Mailing Address - Country:US
Mailing Address - Phone:210-481-7642
Mailing Address - Fax:
Practice Address - Street 1:23530 WILDERNESS OAK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-2406
Practice Address - Country:US
Practice Address - Phone:210-481-7642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX663488183500000X
TX63488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist