| NPI | 1255463642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON METYKO Outpatient Pharmacy Manager 409-772-7127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX 06008) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |