Organization
SANTOS GONZALEZ DBA FRED'S PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANTOS ORLANDO GONZALEZ RPH (OWNER/ PIC)
(956) 655-7557
Entity
Organization
Contact information
Practice address
202 W RICE ST, FALFURRIAS, TX 78355-3704
(361) 325-2662
(361) 325-5177
Mailing address
PO BOX 340, FALFURRIAS, TX 78355-0340
(361) 325-2662
(361) 325-5177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
13433
TX
333600000X
Pharmacy
Primary
13433
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143541
—
TX
01
—
4519673
INSURANCES
TX
Enumeration date
09/01/2005
Last updated
10/13/2020
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