Organization
ST. MARIE CLINIC, P.A. PHARMACY
Active
Parent organization
ST. MARIE CLINIC, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARIE CLINIC, P.A.
Authorized official
EDUARDO CARRILLO MD (CEO)
(956) 585-7401
Entity
Organization
Contact information
Practice address
1905 E. MONTE CRISTO ROAD STE. C, EDINBURG, TX 78541-0333
(956) 287-1831
(956) 287-7832
Mailing address
305 E EXPRESSWAY 83, MISSION, TX 78572-5560
(956) 585-7401
(956) 583-5833
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26174
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26174
STATE LICENSE NUMBER
TX
Enumeration date
07/24/2009
Last updated
07/24/2009
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