=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255141297
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONE TRAIN CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2025
-----------------------------------------------------
Last Update Date | 01/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4501 GROVEWAY DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77087-1122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-485-5432
-----------------------------------------------------
Fax | 713-485-5432
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19318 WATER BRIDGE DR
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77433-3176
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-952-9111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. LUCY MATA BARRACHINA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-952-9111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------