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General NPI Number Information
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NPI Number | 1366082182
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Entity Type | Individual
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Provider Name | ANDREA LYNN MANNIX PHARM D
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Gender | Female
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 5005 N. PIEDRAS STREET
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City | EL PASO
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State | TX
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Zip | 79920
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Country | US
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Telephone | 915-742-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 N ZARAGOZA RD STE 103-1
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City | EL PASO
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State | TX
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Zip | 79938-7981
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Country | US
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Telephone | 915-228-9698
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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 | 52958
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 56167
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License Number State | CA
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