| NPI | 1003229550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN VU Manager 817-688-3778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 29155) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-01-18 |