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NPI Code Detail

MEDICARE: FEEFELOBARI PEACE YORKA PHARMD

MEDICARE: FEEFELOBARI PEACE YORKA PHARMD
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
1183500000XPharmacist60895TX

General Provider Information

NPI Number : 1407462351
Entity Type Code : Individual
Provider Name (Legal Business Name) : FEEFELOBARI PEACE YORKA PHARMD
Provider Business Mailing Address
First Line : 12601 TECH RIDGE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78753-3451
Country : US
Telephone Number : 512-491-6051
Fax Number :
Provider Business Practice Location Address
First Line : 12601 TECH RIDGE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78753-3451
Country : US
Telephone Number : 512-491-6051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2020
Last Update Date : 09/16/2020

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