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General NPI Number Information
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NPI Number | 1730624248
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Entity Type | Organization
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Legal Business Name | REESA BUSINESS LLC
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Dates
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Enumeration Date | 12/20/2016
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Last Update Date | 12/20/2016
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Provider Practice Location Address
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Address Line | 1703 19TH ST
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City | HONDO
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State | TX
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Zip | 78861-2301
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Country | US
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Telephone | 830-426-5000
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Fax | 830-426-5005
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Provider Business Mailing Address
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Address Line | 1705 19TH ST
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City | HONDO
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State | TX
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Zip | 78861-2301
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Country | US
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Telephone | 830-426-5000
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Fax | 830-426-5005
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAFIQ VIRANI
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Credential |
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Telephone | 210-995-4540
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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 |
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License Number State | TX
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