| NPI | 1033301197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT DANCE Pharmacist In Charge 806-378-8843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: TX 24402) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |