# CARVAJAL PHARMACY LTC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carvajal Pharmacy LTC North Texas
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912615998
- **Authorized official:** LISA MARTINEZ CPHT (ADMIN. ASSISTANT)
- **Authorized official phone:** (210) 977-1852

## Contact information

- **Practice address:** 2100 VIRGINIA ST STE I, GRAND PRAIRIE, TX 75051-3796
- **Practice address phone:** (214) 845-7333
- **Mailing address:** 819 S ACME RD, SAN ANTONIO, TX 78237-3202
- **Mailing address phone:** (210) 977-1852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/09/2022
- **Last updated:** 07/17/2025