NPI age
19 years
Enumerated 2006-08-22
Across 5625 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 144770 | |
| 01 (TX) | 19056 | STATE BOARD LICENSE |
| 01 (TX) | 4584024 | NABP |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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