Provider Demographics
NPI:1619201399
Name:RGV DOCTORS PHARMACY
Entity Type:Organization
Organization Name:RGV DOCTORS PHARMACY
Other - Org Name:JUNIORS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMASIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-686-0008
Mailing Address - Street 1:108 E FM 495
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3710
Mailing Address - Country:US
Mailing Address - Phone:956-787-1452
Mailing Address - Fax:
Practice Address - Street 1:108 E FM 495
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3710
Practice Address - Country:US
Practice Address - Phone:956-787-1452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RGV DOCTORS PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty