NPI age
19 years
Enumerated 2006-09-20
Across 2274 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 4507755 | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 05 (TX) | 000460542 |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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