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General NPI Number Information
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NPI Number | 1922130632
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Entity Type | Organization
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Legal Business Name | DE LA ROSA PHARMACY INC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1500 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6606
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Country | US
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Telephone | 956-968-8995
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Fax | 956-969-5728
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Provider Business Mailing Address
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Address Line | 1500 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6606
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Country | US
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Telephone | 956-968-8995
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Fax | 956-969-5728
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Authorized Official
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Title or Position | C.E.O. OWNER
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Name | MR. HECTOR EFRAIN DE LA ROSA
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Credential |
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Telephone | 956-968-8995
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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 | 12051
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 12051
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License Number State | TX
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