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General NPI Number Information
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NPI Number | 1700945227
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Entity Type | Organization
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Legal Business Name | FRY TOVAR INC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 321 S 21ST ST
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City | HARLINGEN
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State | TX
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Zip | 78550-7430
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Country | US
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Telephone | 956-423-1200
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Fax | 956-423-1063
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Provider Business Mailing Address
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Address Line | 321 S 21ST ST
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City | HARLINGEN
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State | TX
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Zip | 78550-7430
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Country | US
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Telephone | 956-423-1200
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Fax | 956-423-1063
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. DANIEL LONGORIA
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Credential | RPH.
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Telephone | 956-423-1200
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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 | 30250
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License Number State | TX
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