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General NPI Number Information
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NPI Number | 1548378227
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Entity Type | Organization
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Legal Business Name | KV EARLY IND
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 680 PAREDES LINE RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2482
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Country | US
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Telephone | 956-542-6050
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Fax | 956-544-5539
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Provider Business Mailing Address
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Address Line | 1080 E LOS EBANOS BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9988
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Country | US
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Telephone | 956-542-6050
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Fax | 956-544-5539
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Authorized Official
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Title or Position | OWNER
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Name | ERASMO CANTU
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Credential |
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Telephone | 956-544-6666
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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 | 18322
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License Number State | TX
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