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Organization
BURTIS DRUG, INC.
Active
Organization
BURTIS DRUG, INC.
Active
Other names
Gibson Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN AUSTIN BURTIS SR. PHA (OWNER)
(972) 579-0511
Entity
Organization
Contact information
Practice address
815 N O CONNOR RD, IRVING, TX 75061-4510
(972) 579-0511
(972) 579-0512
Mailing address
815 N O CONNOR RD, IRVING, TX 75061-4510
(972) 579-0511
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
11854
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4545565
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
06/13/2008
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