Provider Demographics
NPI:1639429921
Name:RANGEL, DANIEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:RANGEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 W MILE 5 RD
Mailing Address - Street 2:STE A
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-6206
Mailing Address - Country:US
Mailing Address - Phone:956-583-9740
Mailing Address - Fax:956-583-9741
Practice Address - Street 1:3204 W MILE 5 RD
Practice Address - Street 2:STE A
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-6206
Practice Address - Country:US
Practice Address - Phone:956-583-9740
Practice Address - Fax:956-583-9741
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX25354OtherTEXAS PHARMACY LICENSE