NPI age
14 years
Enumerated 2011-11-11
Across 2274 active pharmacy providers in Texas.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1679850101 | NPI |
| 01 (TX) | D0185339 | DPS-TEXAS STATE CONTROLLED SUBSTANCE LIC # |
| 01 (TX) | 27755 | RETAIL PHARMACY PERMIT |
| 01 (TX) | 5904431 | NCPDP/NABP |
| 05 (TX) | 146481 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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