Organization
TEXAS PRESCRIPTION PROVIDERS LLC
Active
Other names
Spicewood Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILL SHEPARD (PRESIDENT)
(210) 669-2909
Entity
Organization
Contact information
Practice address
911 W ANDERSON LN, STE 117, AUSTIN, TX 78757-1501
(512) 600-3170
(512) 600-3171
Mailing address
911 W ANDERSON LN STE 117, AUSTIN, TX 78757-1562
(512) 600-3170
(512) 600-3171
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26733
TX
3336I0012X
Institutional Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4554831
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/31/2009
Last updated
04/29/2010
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