| NPI | 1346301413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELBY DAIN GORMAN President 361-853-2061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 23216) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2022-11-07 |