MEDICARE: THE US PHARMACISTS' CLINIC PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133N00000X	Nutritionist
2	1835N1003X	Nutrition Support Pharmacist
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
4	1835P1200X	Pharmacotherapy Pharmacist
5	332B00000X	Durable Medical Equipment & Medical Supplies
6	3336C0003X	Community/Retail Pharmacy
7	183500000X	Pharmacist

General Provider Information

NPI Number	:	1841877040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE US PHARMACISTS' CLINIC PLLC

Provider Business Mailing Address
First Line	:	5969 DALLAS PKWY # 2
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7878
Country	:	US
Telephone Number	:	469-661-2962
Fax Number	:

Provider Business Practice Location Address
First Line	:	5969 DALLAS PKWY # 2
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7878
Country	:	US
Telephone Number	:	469-661-2962
Fax Number	:

Authorized Official
Title or Position	:	CEOI
Name	:	DR. KAZIM O OYENUGA
Credential	:	PHD, MSE
Telephone Number	:	972-905-4911

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	03/25/2021

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