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General NPI Number Information
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NPI Number | 1902129182
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Entity Type | Organization
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Legal Business Name | PEDRO MANUEL YZAGUIRRE JR
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 5235 SOUTHMOST RD SUITE C
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City | BROWNSVILLE
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State | TX
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Zip | 78521-8052
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Country | US
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Telephone | 956-504-9555
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Fax | 956-504-9910
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Provider Business Mailing Address
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Address Line | 5235 SOUTHMOST RD SUITE C
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City | BROWNSVILLE
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State | TX
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Zip | 78521-8052
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Country | US
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Telephone | 956-504-9555
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Fax | 956-504-9910
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Authorized Official
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Title or Position | OWNER/STAFF PHARMACIST
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Name | MR. PEDRO MANUEL YZAGUIRRE JR.
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Credential |
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Telephone | 956-343-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26824
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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