NPI age
10 years
Enumerated 2015-06-04
Across 144 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 5916094 | NCPDP |
| 01 (TX) | 30066 | TEXAS PHARMACY LICENSE |
| 01 | R0219654 | DPS |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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