Andre Efren Estrada
Individual provider Active NPI Pharmacist · Palmhurst, TX
NPI 1821603192 · NPPES record last updated Sep 13, 2020
Key facts
- NPI
- 1821603192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 58657 (TX)
- Practice address
- 4305 N Conway Ave
Palmhurst, TX 78573-1372 - Phone
- (956) 519-7523
- Fax
- (956) 519-7495
- NPI assigned
- Sep 13, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58657 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
4305 N Conway Ave
Palmhurst, TX 78573
Phone (956) 519-7517
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 58657 | TX | Yes |
Addresses
Primary practice location
4305 N Conway Ave
Palmhurst, TX 78573-1372
Mailing address
4305 N Conway Ave
Palmhurst, TX 78573-1372
Phone (956) 519-7523
Other providers in Palmhurst, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2020. 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.