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General NPI Number Information
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NPI Number | 1093299042
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Entity Type | Individual
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Provider Name | MAAX D YONIS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2018
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Last Update Date | 08/24/2024
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Provider Practice Location Address
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Address Line | 2674 S 31ST ST
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City | TEMPLE
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State | TX
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Zip | 76504-7104
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Country | US
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Telephone | 903-565-5777
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 PALUXY DR APT 2093
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City | TYLER
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State | TX
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Zip | 75703-2164
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Country | US
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Telephone | 512-619-5356
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 73404
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License Number State | TX
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