MEDICARE: MARA LISA COBOS R.PH

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	37032	TX

General Provider Information

NPI Number	:	1831791904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARA LISA COBOS R.PH

Provider Business Mailing Address
First Line	:	1010 FRIO ST
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78572-8376
Country	:	US
Telephone Number	:	956-588-5018
Fax Number	:

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2020
Last Update Date	:	06/13/2023

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Directions to “ MARA LISA COBOS R.PH” Practice Location

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