MEDICARE: MARAS PHARMACY LLC

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	3336C0003X	Community/Retail Pharmacy	26761	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2123816	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801967039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARAS PHARMACY LLC

Provider Business Mailing Address
First Line	:	1301 W SAM HOUSTON BLVD UNIT B
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-5669
Country	:	US
Telephone Number	:	956-782-1156
Fax Number	:	956-782-2115

Provider Business Practice Location Address
First Line	:	1301 W SAM HOUSTON BLVD UNIT B
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-5669
Country	:	US
Telephone Number	:	956-782-1156
Fax Number	:	956-782-2115

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE ALBERTO VELA
Credential	:	PHARM.D., R.PH.
Telephone Number	:	956-782-1156

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	02/01/2022

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Directions to “MARAS PHARMACY LLC ” Practice Location

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