NPI age
19 years
Enumerated 2006-12-19
Across 5625 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 4589341 | NCPDP |
| 01 | B0138718 | DPS |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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