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NPI Code Detail

MEDICARE: DR. ANGEL ACOSTA JR. PHARM.D.

MEDICARE: DR. ANGEL ACOSTA JR. 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
1183500000XPharmacist57857TX

General Provider Information

NPI Number : 1861095382
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGEL ACOSTA JR. PHARM.D.
Provider Business Mailing Address
First Line : 511 E LYNN CREEK DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-5456
Country : US
Telephone Number : 682-226-3759
Fax Number :
Provider Business Practice Location Address
First Line : 2323 W ILLINOIS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75224-1637
Country : US
Telephone Number : 214-331-5466
Fax Number : 214-467-4417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2020
Last Update Date : 11/18/2020

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