MEDICARE: EMMANUEL VALVERDE 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	58915	TX

General Provider Information

NPI Number	:	1316547862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL VALVERDE PHARMD

Provider Business Mailing Address
First Line	:	300 KINGS FORT PKWY
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-3575
Country	:	US
Telephone Number	:	469-595-7076
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 KINGS FORT PKWY
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-3575
Country	:	US
Telephone Number	:	469-595-7076
Fax Number	:	469-595-7069

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

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	11/24/2020

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