Mario Juarez Jr., R.PH.
Individual provider Active NPI Pharmacist · Monahans, TX
NPI 1669746335 · NPPES record last updated Feb 28, 2012
Key facts
- NPI
- 1669746335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 38437 (TX)
- Practice address
- 801 E 4TH St
Monahans, TX 79756-4018 - Phone
- (432) 943-4365
- Fax
- (432) 943-7501
- NPI assigned
- Feb 28, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38437 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 38437 | TX | Yes |
Addresses
Primary practice location
801 E 4TH St
Monahans, TX 79756-4018
Mailing address
801 E 4TH St
Monahans, TX 79756-4018
Phone (432) 943-4365
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108432901 | Medicaid | TX | |
| 013677201 | Medicaid | TX |
Other providers in Monahans, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.