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General NPI Number Information
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NPI Number | 1396191862
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Entity Type | Organization
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Legal Business Name | MED CREATIONS,LLC
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 3218 BELTLINE RD SUITE 510
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City | FARMERS BRANCH
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State | TX
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Zip | 75234
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Country | US
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Telephone | 844-231-2565
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Fax | 844-244-2838
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Provider Business Mailing Address
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Address Line | 3218 BELTLINE RD SUITE 510
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City | FARMERS BRANCH
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State | TX
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Zip | 75234
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Country | US
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Telephone | 844-231-2565
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Fax | 844-244-2838
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JACK DEAR
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Credential |
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Telephone | 844-231-2565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332100000X
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Taxonomy Name | Department of Veterans Affairs (VA) Pharmacy
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License Number | 1001667
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License Number State | TX
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