Organization
TEXAS PRESCRIPTION PROVIDERS LLC
Active
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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