NPI age
19 years
Enumerated 2006-07-24
Across 144 active pharmacy providers in Texas.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 4595469 | NCPDP |
| 05 (TX) | 068781601 | |
| 01 (TX) | 320205 | TX VENDOR DRUG |
| 01 (TX) | 19971 | CLASS A LIC |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 20 individual providers on file at this primary address.
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