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General NPI Number Information
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NPI Number | 1639511454
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Entity Type | Organization
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Legal Business Name | W-TEE PHARMACY INC
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 12650 N BEACH ST STE 112
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City | FORT WORTH
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State | TX
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Zip | 76244
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Country | US
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Telephone | 214-467-9009
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Fax |
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Provider Business Mailing Address
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Address Line | 12650 N BEACH ST STE 112
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City | FORT WORTH
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State | TX
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Zip | 76244-4248
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Country | US
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Telephone | 214-467-9009
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MOKY CHEUNG
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Credential |
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Telephone | 817-329-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28545
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License Number State | TX
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