Healthcare Provider Details

I. General information

NPI: 1306367727
Provider Name (Legal Business Name): TERRASCON HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7623 LOUETTA RD STE 104B
SPRING TX
77379-7237
US

IV. Provider business mailing address

7623 LOUETTA RD STE 104B
SPRING TX
77379-7237
US

V. Phone/Fax

Practice location:
  • Phone: 832-374-8090
  • Fax: 832-953-2927
Mailing address:
  • Phone: 832-374-8090
  • Fax: 832-953-2927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY WILLIAMS
Title or Position: OFFICER
Credential: RN
Phone: 832-374-8090