| NPI | 1275676439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HOLLOWAY Manager 817-571-3374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 12419) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |