=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467090548
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NPS CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2019
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8801 WOODWAY DR STE D
-----------------------------------------------------
City | WOODWAY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76712-3646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-294-1400
-----------------------------------------------------
Fax | 254-294-1903
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8801 WOODWAY DR STE D
-----------------------------------------------------
City | WOODWAY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76712-3646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-294-1400
-----------------------------------------------------
Fax | 254-294-1903
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MR. CHARLES ROBERT PORTER
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 254-294-1400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------