Individual
EDDILISA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1201 N BEACH ST, FORT WORTH, TX 76111-6043
(817) 834-6369
Mailing address
1201 N BEACH ST, FORT WORTH, TX 76111-6043
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37909
TX
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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