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NPI Code Detail

MEDICARE: MARY LU PHARM D

MEDICARE: MARY LU 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
1183500000XPharmacist47180TX

General Provider Information

NPI Number : 1578164877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LU PHARM D
Provider Business Mailing Address
First Line : 1200 E SPRING CREEK PKWY
Second Line :
City : PLANO
State : TX
Zip : 75074-3023
Country : US
Telephone Number : 972-516-8525
Fax Number : 972-516-8526
Provider Business Practice Location Address
First Line : 1200 E SPRING CREEK PKWY
Second Line :
City : PLANO
State : TX
Zip : 75074-3023
Country : US
Telephone Number : 972-516-8525
Fax Number : 972-516-8526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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Directions to “ MARY LU PHARM D” Practice Location

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