MEDICARE: PAULNEIL MANGILA GARCIA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	45509	TX

General Provider Information

NPI Number	:	1265027189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULNEIL MANGILA GARCIA PHARMD

Provider Business Mailing Address
First Line	:	5401 WASHINGTON AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5131
Country	:	US
Telephone Number	:	713-861-3883
Fax Number	:	713-863-7160

Provider Business Practice Location Address
First Line	:	5401 WASHINGTON AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5131
Country	:	US
Telephone Number	:	713-861-3883
Fax Number	:	713-863-7160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/02/2021

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