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General NPI Number Information
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NPI Number | 1467146027
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Entity Type | Individual
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Provider Name | JOSE L PENA RPH
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Gender | Male
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 202 W RICE ST
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City | FALFURRIAS
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State | TX
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Zip | 78355-3704
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Country | US
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Telephone | 361-325-2662
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 MULBERRY DR
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City | WESLACO
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State | TX
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Zip | 78596-5505
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Country | US
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Telephone | 361-813-6706
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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 | 25347
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License Number State | TX
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