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General NPI Number Information
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NPI Number | 1639590995
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Entity Type | Organization
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Legal Business Name | AGATENO TECHNOLOGIES LLC
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 3648 OLD DENTON RD STE 104
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City | CARROLLTON
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State | TX
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Zip | 75007-7977
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Country | US
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Telephone | 214-800-5526
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Fax | 214-329-1203
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Provider Business Mailing Address
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Address Line | 3648 OLD DENTON RD STE 104
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City | CARROLLTON
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State | TX
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Zip | 75007-7977
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Country | US
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Telephone | 214-800-5526
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Fax | 214-329-1203
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. SHINU PUNNOOSE
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Credential |
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Telephone | 214-800-5526
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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 | 28947
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License Number State | TX
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