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General NPI Number Information
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NPI Number | 1306195615
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Entity Type | Organization
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Legal Business Name | PARKWOOD PHARMACY
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 3415 S COOPER ST STE 106
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City | ARLINGTON
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State | TX
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Zip | 76015-3434
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Country | US
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Telephone | 817-642-5613
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 S COOPER ST STE 106
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City | ARLINGTON
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State | TX
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Zip | 76015-3434
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Country | US
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Telephone | 817-642-5613
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MR. THAI PHAM
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Credential | OFFICER
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Telephone | 817-642-5613
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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 | 28125
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License Number State | TX
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