Provider Demographics
NPI:1871173799
Name:HERITAGE, RUBY LAYLA (RPHT)
Entity type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:LAYLA
Last Name:HERITAGE
Suffix:
Gender:F
Credentials:RPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17238 BULVERDE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-2401
Mailing Address - Country:US
Mailing Address - Phone:210-938-8000
Mailing Address - Fax:
Practice Address - Street 1:17238 BULVERDE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-2401
Practice Address - Country:US
Practice Address - Phone:210-938-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician