NPI age
19 years
Enumerated 2007-03-29
Across 18509 active pharmacist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 16435 | PERSONAL PHARMACY LICENSE |
| 01 (TX) | 02472 | PHARMACY STORE NUMBER |
| 05 (TX) | 143922 | |
| 01 (TX) | 20002809 | DPS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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