MEDICARE: TX PERFORMANCE MEDS PHARMACY & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy

General Provider Information

NPI Number	:	1134962087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TX PERFORMANCE MEDS PHARMACY & WELLNESS

Provider Business Mailing Address
First Line	:	1646 BLAISDALE RD STE 2200
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-2773
Country	:	US
Telephone Number	:	346-899-8976
Fax Number	:	832-327-8774

Provider Business Practice Location Address
First Line	:	1646 BLAISDALE RD STE 2200
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-2773
Country	:	US
Telephone Number	:	346-899-8976
Fax Number	:	832-327-8774

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	EUGENIA SHEPHERD
Credential	:
Telephone Number	:	346-899-8976

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	06/18/2024

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Directions to “TX PERFORMANCE MEDS PHARMACY & WELLNESS ” Practice Location

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