| NPI | 1124459870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA B NGUYEN Officer 817-453-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 28907) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |