Organization
MINYARD FOOD STORES INC.
Active
Other names
Carnival Pharmacy #119
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. BYARS (PRESIDENT/CEO)
(972) 393-8700
Entity
Organization
Contact information
Practice address
3460 WEBB CHAPEL EXT, DALLAS, TX 75220-6751
(214) 358-3395
(214) 350-6272
Mailing address
3460 WEBB CHAPEL EXT, DALLAS, TX 75220-6751
(214) 358-3395
(214) 350-6272
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
17303
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4503555
NCPDP
TX
05
—
464134
—
TX
Enumeration date
11/01/2006
Last updated
11/15/2007
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