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General NPI Number Information
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NPI Number | 1629873583
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Entity Type | Organization
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Legal Business Name | MERMAID WALKING INC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 409 W FM 495
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City | SAN JUAN
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State | TX
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Zip | 78589-3717
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Country | US
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Telephone | 956-601-0140
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Fax | 833-998-4116
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Provider Business Mailing Address
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Address Line | 409 W FM 495
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City | SAN JUAN
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State | TX
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Zip | 78589-3717
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Country | US
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Telephone | 956-601-0140
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Fax | 833-998-4116
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | JOSE G VARGAS
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Credential | CPHT
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Telephone | 956-534-6990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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