NPI age
18 years
Enumerated 2007-09-28
Across 144 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 2104355 | PK |
| 05 (TX) | 068690902 |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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