Organization
HALTOM PHARMACY LLC
Active
Other names
Haltom Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
THANH QUANG NGO (PHARMACIST)
(817) 838-2500
Entity
Organization
Contact information
Practice address
3602 MATLOCK RD STE 204, ARLINGTON, TX 76015-3600
(817) 838-2500
(817) 838-2510
Mailing address
3602 MATLOCK RD STE 204, ARLINGTON, TX 76015-3600
(817) 838-2500
(817) 838-2510
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
24360
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145592
—
TX
01
—
2098722
PK
—
Enumeration date
06/22/2006
Last updated
12/31/2018
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