Provider Demographics
NPI:1780980862
Name:ZALCON PHARMACY
Entity type:Organization
Organization Name:ZALCON PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONWUMERE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-939-4559
Mailing Address - Street 1:4 TRAILSIDE CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5463
Mailing Address - Country:US
Mailing Address - Phone:817-939-4559
Mailing Address - Fax:
Practice Address - Street 1:9101 LAKEVIEW PKW
Practice Address - Street 2:STE. 500
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088
Practice Address - Country:US
Practice Address - Phone:972-412-7842
Practice Address - Fax:972-412-9884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty