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General NPI Number Information
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NPI Number | 1871882886
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Entity Type | Organization
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Legal Business Name | PALOMA'S PHARMACY,LLC
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 909 BUSINESS PARK DR STE 2
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City | MISSION
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State | TX
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Zip | 78572-6054
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Country | US
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Telephone | 956-424-6268
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Fax | 956-424-6258
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Provider Business Mailing Address
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Address Line | 909 BUSINESS PARK DR
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City | MISSION
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State | TX
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Zip | 78572-6052
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Country | US
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Telephone | 956-424-6268
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Fax | 956-424-6258
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Authorized Official
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Title or Position | CORP-PRESIDENT
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Name | MR. JOSE A VELA
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Credential | PHARM.D, R.PH.
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Telephone | 956-821-2886
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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 | 27433
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License Number State | TX
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