Organization
TERRASCON HEALTHCARE CORPORATION
Active
Other names
Kleinwood Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY WILLIAMS (OFFICER)
(832) 953-2926
Entity
Organization
Contact information
Practice address
7623 LOUETTA RD STE 104, SPRING, TX 77379-7237
(832) 953-2926
(832) 953-2927
Mailing address
7623 LOUETTA RD STE 104, SPRING, TX 77379-7237
(832) 953-2926
(832) 953-2927
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31443
TX
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169409
PK
—
Enumeration date
07/28/2017
Last updated
07/28/2017
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