Provider Demographics
NPI:1942790530
Name:THE OTHER GUYS PHARMACY, INC.
Entity Type:Organization
Organization Name:THE OTHER GUYS PHARMACY, INC.
Other - Org Name:THE OTHER GUYS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMD
Authorized Official - Prefix:
Authorized Official - First Name:SEM
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-460-1834
Mailing Address - Street 1:1305 W VILLA ST
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-9359
Mailing Address - Country:US
Mailing Address - Phone:956-460-1834
Mailing Address - Fax:
Practice Address - Street 1:1116 E 8TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7288
Practice Address - Country:US
Practice Address - Phone:956-405-3232
Practice Address - Fax:956-405-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX320593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177727OtherPK