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General NPI Number Information
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NPI Number | 1184688921
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Entity Type | Organization
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Legal Business Name | YODORINCMISSIONPLAZAPHARMACY
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 906 S BRYAN RD STE 101A
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City | MISSION
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State | TX
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Zip | 78572-6605
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Country | US
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Telephone | 956-581-8833
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Fax | 956-581-0364
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Provider Business Mailing Address
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Address Line | 1611 HERITAGE LN
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City | MISSION
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State | TX
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Zip | 78572-4529
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Country | US
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Telephone | 956-581-8833
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Fax | 956-581-0364
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Authorized Official
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Title or Position | VP, SECRETARY, PHARMACIST
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Name | MRS. DORA G ESPINOZA
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Credential |
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Telephone | 956-581-8833
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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 | 15042
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 148627
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 148627
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License Number State | TX
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