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General NPI Number Information
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NPI Number | 1942200738
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Entity Type | Individual
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Provider Name | TOMAS LUIS IZAGUIRRE III PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1219 MATAMOROS ST
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City | LAREDO
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State | TX
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Zip | 78040-5053
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Country | US
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Telephone | 956-726-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 SERENE DR
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City | LAREDO
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State | TX
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Zip | 78045-8049
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Country | US
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Telephone | 956-722-0915
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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 | 42943
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License Number State | TX
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