MEDICARE: TOTAL VEIN PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	29292	TX
2	3336C0004X	Compounding Pharmacy

General Provider Information

NPI Number	:	1346653367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL VEIN PHARMACY

Provider Business Mailing Address
First Line	:	7920 ELMBROOK DR STE 108
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4933
Country	:	US
Telephone Number	:	888-277-7002
Fax Number	:	972-457-1490

Provider Business Practice Location Address
First Line	:	7920 ELMBROOK DR STE 108
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-4933
Country	:	US
Telephone Number	:	888-277-7002
Fax Number	:	972-457-1490

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DAVID SCOTT BOONE
Credential	:
Telephone Number	:	888-277-7002

Provider Enumeration Date	:	06/06/2014
Last Update Date	:	01/24/2024

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Directions to “TOTAL VEIN PHARMACY ” Practice Location

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