Organization
TACKETT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ANDREW TACKETT PHARMACIST (OWNER PHARMACIST IN CHARGE)
(817) 694-7360
Entity
Organization
Contact information
Practice address
132 EL CHICO TRL, WILLOW PARK, TX 76087-8865
(817) 441-7046
(817) 441-5731
Mailing address
132 EL CHICO TRL, WILLOW PARK, TX 76087-8865
(817) 441-7046
(817) 441-5731
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
06761
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142289
—
TX
Enumeration date
10/04/2006
Last updated
07/21/2008
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