Organization
MIXLAB TX, LLC
Active
Parent organization
MIXLAB, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIXLAB, INC.
Authorized official
VINNEI DAM PHARMD, MS (CHIEF PHARMACY OFFICER)
(347) 610-9820
Entity
Organization
Contact information
Practice address
953 HILLTOP DR, WEATHERFORD, TX 76086-8811
(888) 901-4480
Mailing address
953 HILLTOP DR, WEATHERFORD, TX 76086-8811
(888) 901-4480
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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