Healthcare Provider Details

I. General information

NPI: 1912001983
Provider Name (Legal Business Name): VINA PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 SETON CENTER PKWY STE 115
AUSTIN TX
78759-5295
US

IV. Provider business mailing address

4700 SETON CENTER PKWY STE 115
AUSTIN TX
78759-5295
US

V. Phone/Fax

Practice location:
  • Phone: 512-372-0440
  • Fax: 512-372-0442
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number25203
License Number StateTX

VIII. Authorized Official

Name: GARY RAGLAND
Title or Position: PIC
Credential: RPH
Phone: 512-970-7326