MEDICARE: KROGER TEXAS LIMITED PARTNERSHIP

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	22260	TX
2	3336C0003X	Community/Retail Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4524042	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942373469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KROGER TEXAS LIMITED PARTNERSHIP

Provider Business Mailing Address
First Line	:	19245 DAVID MEMORIAL DR
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77385-8778
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6479 CAMP BOWIE BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-4356
Country	:	US
Telephone Number	:	817-738-9100
Fax Number	:	817-738-1957

Authorized Official
Title or Position	:	PHARMACY MERCHANDISER
Name	:	BYRON COOLEY
Credential	:
Telephone Number	:	713-507-6276

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1003508342 — MORGAN WILLIAMS
Practice Location Address:

6479 CAMP BOWIE BLVD STE 165
FORT WORTH, TX
76116-4356

Practice Phone: 817-300-9224
Practice Fax:

1477338150 — EMMA NORTON LPC
Practice Location Address:

6479 CAMP BOWIE BLVD
FORT WORTH, TX
76116-4356

Practice Phone: 214-403-2275
Practice Fax:

1326607409 — MONIQUE LAREVIERE
Practice Location Address:

4356 EMERALD VIS
LAKE WORTH, FL
33461-5384

Practice Phone: 561-729-8677
Practice Fax:

1841296670 — DR. STEPHEN A. RENAE M.D.
Practice Location Address:

3012 E COMMERCIAL BLVD
FORT LAUDERDALE, FL
33308-4356

Practice Phone: 954-776-9992
Practice Fax: 954-776-9993

1134201924 — US1 PHARMACY INC
Practice Location Address:

4356 N FEDERAL HWY
FORT LAUDERDALE, FL
33308-5208

Practice Phone: 954-302-8478
Practice Fax: 954-793-4862

1861557811 — PATRICIA CORRENTE LPC, CAC III
Practice Location Address:

1638 ELWELL ST BLDG 6236
FORT CARSON, CO
80913-4356

Practice Phone: 719-526-8560
Practice Fax: 719-526-8758

Directions to “KROGER TEXAS LIMITED PARTNERSHIP ” 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.