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General NPI Number Information
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NPI Number | 1497031447
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Entity Type | Organization
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Legal Business Name | NUVISION PHARMACY, INC
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 4001 MCEWEN RD STE 110
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City | DALLAS
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State | TX
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Zip | 75244-5020
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Country | US
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Telephone | 214-347-4008
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Fax | 214-269-0243
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Provider Business Mailing Address
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Address Line | 4001 MCEWEN RD SUITE 110
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City | DALLAS
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State | TX
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Zip | 75244-5020
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Country | US
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Telephone | 214-347-4008
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Fax | 214-269-0243
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Authorized Official
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Title or Position | PIC
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Name | LOYD NEAL
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Credential |
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Telephone | 214-347-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 27468
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License Number State | TX
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