| NPI | 1003800160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR JIMENEZ Pharmacist In Charge/Manager 903-432-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 04235) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2020-08-22 |