| NPI | 1801107123 |
|---|---|
| Doing Business As | MIRA VISTA APOTHECARY |
| Entity Type | Organization |
| Authorized Contact | MONI SAGOO Director Of Pharmacy 817-292-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 26982) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2018-07-19 |