Individual
BOLA GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2050 N HIGHWAY 78, WYLIE, TX 75098-6043
(972) 429-5106
Mailing address
PO BOX 2636, WYLIE, TX 75098-2636
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
33939
TX
Other
Enumeration date
03/07/2012
Last updated
10/07/2016
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