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General NPI Number Information
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NPI Number | 1578858478
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Entity Type | Individual
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Provider Name | BRIAN SISOLAK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 7400 N 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78504-7700
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Country | US
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Telephone | 956-686-9260
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 N CROSS LN APT B
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City | EDINBURG
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State | TX
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Zip | 78541-3485
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Country | US
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Telephone | 702-525-9337
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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 | 49683
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17927
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License Number State | NV
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