| NPI | 1750332441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL KAY MCDONALD Provider 817-810-9810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-01-04 |