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General NPI Number Information
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NPI Number | 1740751759
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Entity Type | Organization
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Legal Business Name | WYNDHAM PHARMACY INC
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 903 MEDICAL CENTRE DR STE C
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City | ARLINGTON
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State | TX
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Zip | 76012-4754
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Country | US
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Telephone | 682-270-8779
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Fax | 682-238-0748
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Provider Business Mailing Address
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Address Line | 903 MEDICAL CENTRE DR STE C
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City | ARLINGTON
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State | TX
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Zip | 76012-4754
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Country | US
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Telephone | 682-270-8779
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Fax | 682-238-0748
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Authorized Official
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Title or Position | PHARMACY MANAGER (PIC)
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Name | TUYEN JENNY VO
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Credential | RPH
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Telephone | 682-270-8779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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