Organization
MINYARD FOOD STORES INC.
Active
Other names
Carnvial Pharmacy #125
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. BYARS (PRESIDENT/CEO)
(972) 393-8700
Entity
Organization
Contact information
Practice address
1706 W IRVING BLVD, IRVING, TX 75061-7137
(972) 254-4179
(972) 259-3904
Mailing address
1706 W IRVING BLVD, IRVING, TX 75061-7137
(972) 254-4179
(972) 259-3904
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10942
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142845
—
TX
01
—
4570722
NABP ID#
TX
Enumeration date
11/01/2006
Last updated
11/16/2007
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