NPI age
20 years
Enumerated 2005-09-22
Across 18509 active pharmacist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 145392 | |
| 01 (TX) | 23175 | STATE LIC# |
| 01 | 4510827 | NCPDP# |
Solo or small practice. No other active providers share this practice address in NPPES.
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