Provider Demographics
NPI:1245385400
Name:PEDRO MANUEL YZAGUIRRE
Entity Type:Organization
Organization Name:PEDRO MANUEL YZAGUIRRE
Other - Org Name:PETE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:YZAGUIRRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-425-2424
Mailing Address - Street 1:721 W HARRISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6016
Mailing Address - Country:US
Mailing Address - Phone:956-425-2424
Mailing Address - Fax:956-425-2428
Practice Address - Street 1:721 W HARRISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6016
Practice Address - Country:US
Practice Address - Phone:956-425-2424
Practice Address - Fax:956-425-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24291333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy