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Individual

ANTHONY TA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH

Contact information

Practice address
101 E SOUTHWEST PKWY STE 115, LEWISVILLE, TX 75067-2315
(972) 702-2006
Mailing address
101 E SOUTHWEST PKWY STE 115, LEWISVILLE, TX 75067-2315
(469) 702-2006

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36361
TX

Other

Enumeration date
06/10/2019
Last updated
11/04/2019
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