Organization
MINYARD FOOD STORES INC.
Active
Other names
Carvnival Pharmacy #123
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. BYARS (PRESIDENT/CEO)
(972) 393-8700
Entity
Organization
Contact information
Practice address
912 W 12TH ST, DALLAS, TX 75208-6005
(214) 943-4161
(214) 942-9911
Mailing address
912 W 12TH ST, DALLAS, TX 75208-6005
(214) 943-4161
(214) 942-9911
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
13462
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4580038
NABP ID#
TX
05
—
463062
—
TX
Enumeration date
11/01/2006
Last updated
11/16/2007
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