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Organization
DAUGHTERS OF CHARITY HLTH SRVS OF AUSTIN
Active
Organization
DAUGHTERS OF CHARITY HLTH SRVS OF AUSTIN
Active
Other names
NOT JUST FOR PEDIATRICS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON KOENNING PHARMD (PIC)
(512) 324-8820
Entity
Organization
Contact information
Practice address
1301 BARBARA JORDAN BLVD, STE 102, AUSTIN, TX 78723-3077
(512) 324-0903
(512) 324-0640
Mailing address
1301 BARBARA JORDAN BLVD, STE 102, AUSTIN, TX 78723-3077
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
22534
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250473
—
TX
01
—
4528088
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/25/2006
Last updated
07/20/2007
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