MEDICARE: FORT WORTH PHARMACY LLC

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
2	3336C0003X	Community/Retail Pharmacy	30317	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2099205	OTHER		PK

General Provider Information

NPI Number	:	1881708873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT WORTH PHARMACY LLC

Provider Business Mailing Address
First Line	:	7833 OAKMONT BLVD
Second Line	:	SUITE 120
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4231
Country	:	US
Telephone Number	:	817-361-9960
Fax Number	:	817-361-9970

Provider Business Practice Location Address
First Line	:	7833 OAKMONT BLVD
Second Line	:	SUITE 120
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4231
Country	:	US
Telephone Number	:	817-361-9960
Fax Number	:	817-361-9970

Authorized Official
Title or Position	:	OWNER
Name	:	CREIGHTON MAYNARD
Credential	:	BS
Telephone Number	:	817-361-9960

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	09/17/2021

Similar Medicare Providers

1417067570 — MRS. BETH ANN CALHOUN LPC
Practice Location Address:

7833 OAKMONT BLVD
FT WORTH, TX
76132-4231

Practice Phone: 817-243-8195
Practice Fax:

1235314899 — PSYCHOTHERAPY, TRAINING AND EDUCATION CENTER, INC.
Practice Location Address:

7833 OAKMONT BLVD , SUITE 110
FORT WORTH, TX
76132-4231

Practice Phone: 817-665-0583
Practice Fax: 817-370-8977

1740412204 — OAKMONT COUNSELING CENTER
Practice Location Address:

7833 OAKMONT BLVD , # 110
FORT WORTH, TX
76132-4231

Practice Phone: 817-665-0583
Practice Fax: 817-370-8977

1205116407 — GAY S KELSO, DBA SOLUTION FOCUSED COUNSELING
Practice Location Address:

7833 OAKMONT BLVD , SUITE 110
FORT WORTH, TX
76132-4231

Practice Phone: 817-665-0583
Practice Fax: 817-370-8977

1750630893 — JOAN KERLEY LPC
Practice Location Address:

7833 OAKMONT BLVD
FORT WORTH, TX
76132-4231

Practice Phone: 817-944-0064
Practice Fax:

1912250309 — JDK COUNSELING SERVICES LLC
Practice Location Address:

7833 OAKMONT BLVD
FORT WORTH, TX
76132-4231

Practice Phone: 817-944-0064
Practice Fax: 817-370-8977

Directions to “FORT WORTH PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.