NPI age
17 years
Enumerated 2009-03-03
Across 589 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 2119221 | PK |
| 05 (TX) | 350220 |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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