NPI age
19 years
Enumerated 2007-04-10
Across 139 active pharmacy providers in Texas.
6 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 25670 | STATE LICENSE |
| 01 (TX) | R0155996 | DPS LICENSE |
| 01 (OK) | 99-1242 | NON-RESIDENT |
Multi-provider organization. 6 individual providers on file at this primary address.
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