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General NPI Number Information
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NPI Number | 1720110927
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Entity Type | Organization
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Legal Business Name | TEXAS THCP OPERATIONS, LP
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7413 PEBBLE DR
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City | FORT WORTH
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State | TX
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Zip | 76118-6962
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Country | US
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Telephone | 817-595-9770
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Fax | 817-595-1157
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Provider Business Mailing Address
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Address Line | 7413 PEBBLE DR
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City | FORT WORTH
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State | TX
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Zip | 76118-6962
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Country | US
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Telephone | 817-595-9770
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Fax | 817-595-1157
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Authorized Official
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Title or Position | OWNER
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Name | DARYL SPENCE
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Credential |
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Telephone | 817-595-9770
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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 | 22671
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License Number State | TX
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