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Organization

CENTRO PEDIATRIC PHARMACY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACKSON DANG (PIC)
(817) 369-8988
Entity
Organization

Contact information

Practice address
7200 GLENVIEW DR STE 1, RICHLAND HILLS, TX 76180-7612
(817) 369-8988
(817) 369-8991
Mailing address
7200 GLENVIEW DR STE 1, RICHLAND HILLS, TX 76180-7612
(817) 537-2899
(817) 977-9099

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26940
TX
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2162498
PK
Enumeration date
06/02/2010
Last updated
10/19/2017
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