Individual
BRYANT ALEXIS PAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
980 US HIGHWAY 491, GALLUP, NM 87301-5339
(915) 274-7289
Mailing address
711 W WILSON AVE, GALLUP, NM 87301-5334
(915) 274-7289
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
74389
TX
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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