Healthcare Provider Details

I. General information

NPI: 1093806408
Provider Name (Legal Business Name): RGV DOCTORS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5416 S JACKSON RD STE B
EDINBURG TX
78539-8332
US

IV. Provider business mailing address

5416 S JACKSON RD STE B
EDINBURG TX
78539-8332
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-0008
  • Fax: 956-213-8135
Mailing address:
  • Phone: 956-686-0008
  • Fax: 956-213-8135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number24151
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number26356
License Number StateTX

VIII. Authorized Official

Name: LEONEL GUERRERO
Title or Position: CHIEF PHARMACIST
Credential: RPH
Phone: 956-686-0008