=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073147609
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVANCED RX CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2020
-----------------------------------------------------
Last Update Date | 02/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 821 DUSTY TRL
-----------------------------------------------------
City | AUBREY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76227-1527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-228-9718
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 821 DUSTY TRL
-----------------------------------------------------
City | AUBREY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76227-1527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-228-9718
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. PETRA T ZAMORA
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 214-228-9718
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------