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General NPI Number Information
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NPI Number | 1326599499
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Entity Type | Organization
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Legal Business Name | TEXAS HEALTH MEDICAL SUPPORT
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 1100 BRIDGEWOOD DR STE 107
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City | FORT WORTH
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State | TX
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Zip | 76112-0808
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Country | US
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Telephone | 682-236-2550
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Fax | 682-236-0050
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Provider Business Mailing Address
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Address Line | 600 E. LAMAR BLVD.
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City | ARLINGTON
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State | TX
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Zip | 76011-4116
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF PHARMACY SERVICES
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Name | RANDY BALL
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Credential |
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Telephone | 682-236-2550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 31560
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License Number State | TX
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