1538884564 NPI number — DISCOUNT PHARMACY, PLLC

Table of content: (NPI 1538884564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538884564 NPI number — DISCOUNT PHARMACY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DISCOUNT PHARMACY, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMPLETE RX PHARMACY #4
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538884564
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 E PRICE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78521-4215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-442-5727
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 E ALTON GLOOR BLVD UPPR B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78526-4296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-442-5727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VELA
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
956-265-9634

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 150589 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1720680432 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".