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NPI Code Detail

MEDICARE: MR. JACK E AYOUB R.PH.

MEDICARE: MR. JACK E AYOUB R.PH.
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
1183500000XPharmacist20734TX

General Provider Information

NPI Number : 1407198757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACK E AYOUB R.PH.
Provider Business Mailing Address
First Line : 2420 E WASHINGTON AVE
Second Line :
City : HARLINGEN
State : TX
Zip : 78550-2731
Country : US
Telephone Number : 956-574-9707
Fax Number : 956-574-9715
Provider Business Practice Location Address
First Line : 2155 PAREDES LINE RD
Second Line : HEB PHARMACY,#446
City : BROWNSVILLE
State : TX
Zip : 78521-1609
Country : US
Telephone Number : 956-574-9707
Fax Number : 956-574-9715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 04/10/2013

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Directions to “ MR. JACK E AYOUB R.PH.” Practice Location

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