MEDICARE: ROXANA MYRA APACIBLE PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	51197	TX

General Provider Information

NPI Number	:	1356603518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANA MYRA APACIBLE PHARM.D.

Provider Business Mailing Address
First Line	:	3550 S GENERAL BRUCE DR
Second Line	:	T-2278
City	:	TEMPLE
State	:	TX
Zip	:	76504-5138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 S GENERAL BRUCE DR
Second Line	:	T-2278
City	:	TEMPLE
State	:	TX
Zip	:	76504-5138
Country	:	US
Telephone Number	:	254-295-1057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	06/13/2012

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