Organization
TEXAN PHARMACY LLC
Active
Other names
FREEPORT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMISH KORDIA (PHARMACIST IN CHARGE, DIRECTOR)
(410) 900-6283
Entity
Organization
Contact information
Practice address
323 S BRAZOSPORT BLVD, FREEPORT, TX 77541-4506
(979) 871-9189
(979) 871-9257
Mailing address
323 S BRAZOSPORT BLVD, FREEPORT, TX 77541-4506
(979) 871-9189
(979) 871-9257
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140008
PK
—
Enumeration date
04/23/2013
Last updated
04/23/2013
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