NPI age
19 years
Enumerated 2007-03-02
Across 5625 active pharmacy providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 4520789 | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 05 (TX) | ILPACP432W686 | |
| 01 | 4520789 | OTHER ID NUMBER |
Multi-provider organization. 1 individual provider on file at this primary address.
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