Organization
CHOICE SOURCE THERAPEUTIC OF HOUSTON, TEXAS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WILLIAM BORDER (AUTHORIZED SIGNER)
(800) 225-5967
Entity
Organization
Contact information
Practice address
20333 STATE HIGHWAY 249, SUITE 450, HOUSTON, TX 77070
(281) 257-7900
(281) 257-7920
Mailing address
PO BOX 840688, DALLAS, TX 75284-0688
(800) 225-5967
(909) 799-4364
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
19617
TX
333600000X
Pharmacy
19617
TX
3336H0001X
Home Infusion Therapy Pharmacy
19617
TX
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009914034
—
AL
05
—
091576104
—
TX
05
—
091576105
—
TX
05
—
100245870A
—
OK
05
—
100560035
—
AL
05
—
200422190
—
IN
05
—
2441423
—
OH
01
—
320199
CHIP
TX
05
—
320199
—
TX
01
—
580024
MEDICARE B (TRAILBLAZER)
TX
05
—
806568400
—
ID
01
—
AH05
HEMO ASSISTANCE
TX
Enumeration date
11/08/2005
Last updated
04/23/2010
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