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General NPI Number Information
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NPI Number | 1508917246
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN FAMILY PHARMACY&SOUTHERN MEDICAL FAMILY,INC.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1927 E BELT LINE RD SUITE 146
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City | CARROLLTON
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State | TX
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Zip | 75006-5821
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Country | US
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Telephone | 214-731-3027
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Fax | 214-731-3033
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Provider Business Mailing Address
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Address Line | 1927 E BELT LINE RD SUITE 146
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City | CARROLLTON
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State | TX
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Zip | 75006-5821
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Country | US
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Telephone | 214-731-3027
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Fax | 214-731-3033
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. PA NOUS PAN
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Credential |
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Telephone | 214-731-3027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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