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General NPI Number Information
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NPI Number | 1528285624
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Entity Type | Organization
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Legal Business Name | VELASQUEZ GROUP LP
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 1814 N BILL MACK
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City | SHAMROCK
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State | TX
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Zip | 79079
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Country | US
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Telephone | 806-256-3111
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Fax | 806-256-3551
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Provider Business Mailing Address
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Address Line | PO BOX 767
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City | WHEELER
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State | TX
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Zip | 79096
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Country | US
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Telephone | 806-826-5555
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Fax | 806-826-5560
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Authorized Official
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Title or Position | PHARMACIST
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Name | JIM WAKEFIELD
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Credential |
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Telephone | 806-256-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28931
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License Number State | TX
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