NPI age
12 years
Enumerated 2014-03-26
Across 5625 active pharmacy providers in Texas.
19 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 469101 | |
| 01 (TX) | 29052 | TEXAS STATE BOARD OF PHARMACY |
| 01 (TX) | 5911323 | NCPDP |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 19 individual providers on file at this primary address.
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