NPI age
20 years
Enumerated 2005-11-16
Across 589 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 146101 | |
| 01 | 4539409 | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 05 (TX) | 350231 |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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