Organization
ISA MANAGEMENT SERVICES, LLC
Active
Other names
Gaston Pharmacy # 2
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL IRIZARRY (OPERATIONS MANAGER)
(469) 466-1243
Entity
Organization
Contact information
Practice address
712 N. WASHINGTON AVE, STE 500, DALLAS, TX 75246
(469) 466-1243
(469) 533-4934
Mailing address
712 N. WASHINGTON AVE, STE 500, DALLAS, TX 75246
(469) 466-1243
(469) 533-4934
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
30054
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149167
—
TX
Enumeration date
07/02/2015
Last updated
12/16/2016
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