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Organization
MLDP OF TEXAS LP
Active
Organization
MLDP OF TEXAS LP
Active
Other names
LEGENDS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA DIPAOLO PHARMD (VP OF PHARMACY OPERATIONS)
(210) 510-2692
Entity
Organization
Contact information
Practice address
222 BELL LN STE 5A, WEST MONROE, LA 71291-6303
(318) 998-3018
(318) 998-3020
Mailing address
6601 BLANCO RD, SUITE 201, SAN ANTONIO, TX 78216-6102
(210) 510-2692
(210) 736-4438
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY005579IR
LA
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Enumeration date
09/13/2006
Last updated
03/05/2024
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