Organization
TRI-PHASIC PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AYESHA SIDDIQI (ACCOUNT COORDINATOR)
(817) 784-2400
Entity
Organization
Contact information
Practice address
1700 TECH CENTRE PKWY, SUITE #110-A1, ARLINGTON, TX 76014-4405
(817) 784-2400
(817) 676-9147
Mailing address
1700 TECH CENTRE PKWY, SUITE #110-A1, ARLINGTON, TX 76014-4405
(817) 784-2400
(817) 676-9147
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
22576
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4537152
NCPDP
TX
Enumeration date
08/11/2005
Last updated
08/22/2020
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