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General NPI Number Information
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NPI Number | 1780013680
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Entity Type | Organization
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Legal Business Name | LA FERIA DRUG
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 54 E PRICE RD STE 2
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3508
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Country | US
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Telephone | 956-550-8908
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Fax | 956-550-8911
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Provider Business Mailing Address
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Address Line | 1242 E BUS HWY 83 STE 7
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City | MISSION
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State | TX
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Zip | 78572-9308
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Country | US
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Telephone | 956-583-2700
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Fax | 956-583-2714
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE ALBERTO VELA
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Credential | R.PH.
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Telephone | 956-265-9634
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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 | 28786
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License Number State | TX
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