NPI age
13 years
Enumerated 2012-06-07
Across 70 active pharmacist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (LA) | PST.022028 | LOUISIANA RPH LICENSE |
| 01 (MS) | T-15093 | MISSISSIPPI RPH LICENSE |
| 01 (OK) | 17383 | OKLAHOMA RPH LICENSE |
| 01 (TX) | 55715 | TEXAS RPH LICENSE |
Part of a multi-provider practice. 41 other active providers share this practice address in NPPES.
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