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General NPI Number Information
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NPI Number | 1912780966
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Entity Type | Individual
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Provider Name | PABLO YANEZ
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Gender | Male
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 1720 HILLCREST DR
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City | VERNON
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State | TX
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Zip | 76384-4099
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Country | US
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Telephone | 940-552-2999
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Fax | 940-552-5347
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Provider Business Mailing Address
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Address Line | 400 S BAILEY ST
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City | ELECTRA
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State | TX
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Zip | 76360-2324
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Country | US
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Telephone | 918-855-7547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 72800
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License Number State | TX
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