Organization
BEAR CREEK PHARMACY LLC
Active
Other names
BEAR CREEK PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY SIMO (OWNER/PIC)
(817) 562-4766
Entity
Organization
Contact information
Practice address
101 BEAR CREEK PKWY STE B, KELLER, TX 76248-2531
(817) 562-4766
(817) 562-4871
Mailing address
101 BEAR CREEK PKWY STE B, KELLER, TX 76248-2531
(817) 562-4766
(817) 562-4871
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27405
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129429
PK
—
Enumeration date
01/20/2011
Last updated
10/03/2019
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