| NPI | 1053715490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY PADILLA Pharmacy Supervisor 972-822-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 55743) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |