| NPI | 1760582068 |
|---|---|
| Doing Business As | PROVIDERX OF SAN ANTONIO |
| Entity Type | Organization |
| Authorized Contact | TERRY ALLARD General Manager 817-778-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-05-17 |