MEDICARE: ALICIA VO 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	44466	TX

General Provider Information

NPI Number	:	1578859005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA VO PHARMD

Provider Business Mailing Address
First Line	:	4760 STATE HIGHWAY 121
Second Line	:	TARGET PHARMACY STORE T-2520
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-2913
Country	:	US
Telephone Number	:	469-287-0347
Fax Number	:	469-287-0357

Provider Business Practice Location Address
First Line	:	4760 STATE HIGHWAY 121
Second Line	:	TARGET PHARMACY STORE T-2520
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-2913
Country	:	US
Telephone Number	:	469-287-0347
Fax Number	:	469-287-0357

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

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	06/23/2011

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