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General NPI Number Information
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NPI Number | 1154759926
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Entity Type | Organization
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Legal Business Name | HIW PHARMACY LLC
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 13111 N CENTRAL EXPY SUITE 1000
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City | DALLAS
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State | TX
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Zip | 75243-1138
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Country | US
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Telephone | 469-250-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 13111 N CENTRAL EXPY SUITE 1000
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City | DALLAS
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State | TX
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Zip | 75243-1138
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Country | US
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Telephone | 469-250-1600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON E MALVEAUX
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Credential |
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Telephone | 337-298-9830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State | TX
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