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General NPI Number Information
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NPI Number | 1033516588
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Entity Type | Organization
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Legal Business Name | S. MIAN, LLC
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Dates
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Enumeration Date | 11/28/2014
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 4115 PECAN BLVD STE C
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City | MCALLEN
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State | TX
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Zip | 78501-3695
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Country | US
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Telephone | 956-627-4128
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Fax | 956-627-4416
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Provider Business Mailing Address
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Address Line | 4115 PECAN BLVD STE C
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City | MCALLEN
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State | TX
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Zip | 78501-3695
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Country | US
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Telephone | 956-627-4128
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Fax | 956-627-4416
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. JOSE A VELA
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Credential | PHARMD
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Telephone | 956-583-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 29713
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License Number State | TX
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