Organization
TEXAN PHARMACY LLC
Active
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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