NPI age
19 years
Enumerated 2006-11-06
Across 107 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 250394 | |
| 01 (TX) | 15794 | LICENSE |
| 01 | 2102397 | PK |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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