Healthcare Provider Details

I. General information

NPI: 1205668274
Provider Name (Legal Business Name): ROYAL FAMILY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2024
Last Update Date: 12/09/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 SHILOH RD STE 1200
PLANO TX
75074-7263
US

IV. Provider business mailing address

525 SHILOH RD STE 1200
PLANO TX
75074-7263
US

V. Phone/Fax

Practice location:
  • Phone: 469-324-2900
  • Fax: 469-519-4701
Mailing address:
  • Phone: 469-324-2900
  • Fax: 469-519-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BARRY NZEGWU
Title or Position: OWNER
Credential:
Phone: 469-324-2900