MEDICARE: PATTY HOXTELL

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	34483	TX

General Provider Information

NPI Number	:	1881295830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATTY HOXTELL

Provider Business Mailing Address
First Line	:	1401 ST HWY 100
Second Line	:
City	:	PORT ISABEL
State	:	TX
Zip	:	78578-2480
Country	:	US
Telephone Number	:	956-943-3512
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 ST HWY 100
Second Line	:
City	:	PORT ISABEL
State	:	TX
Zip	:	78578-2480
Country	:	US
Telephone Number	:	956-943-3512
Fax Number	:

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

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	11/05/2020

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Directions to “ PATTY HOXTELL ” Practice Location

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