Organization
LAKE TRAVIS PHARMACY PARTNERS LLC
Active
Other names
Lake Hills Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE MCANALLY (OWNER)
(214) 734-8878
Entity
Organization
Contact information
Practice address
12005 BEE CAVE PKWY STE 1A, AUSTIN, TX 78738-6387
(512) 608-9355
Mailing address
12005 BEE CAVE RD, SUITE 1A, AUSTIN, TX 78738
(512) 608-9355
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28908
TX
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143234
PK
—
Enumeration date
12/06/2013
Last updated
12/06/2013
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