Organization
K V EARLY INC
Active
Other names
CANTU WESTSIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ERASMO CANTU (OWNER)
(956) 544-6666
Entity
Organization
Contact information
Practice address
1080 E LOS EBANOS BLVD, BROWNSVILLE, TX 78520-9988
(956) 544-6666
(956) 544-5539
Mailing address
14 GALLERIA DR, SAN ANTONIO, TX 78257-1216
(956) 346-1008
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
19669
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144901
—
TX
01
—
2097935
PK
—
Enumeration date
08/23/2006
Last updated
07/10/2014
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