Organization
MPN2 PHARMACY MGT LLC
Active
Other names
Texan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MINA SHAH (OFFICER)
(732) 318-9628
Entity
Organization
Contact information
Practice address
3100 RR 620 S STE 500, LAKEWAY, TX 78738-5635
(512) 270-2311
(512) 270-2326
Mailing address
3100 RR 620 S STE 500, LAKEWAY, TX 78738-5635
(512) 270-2311
(512) 270-2326
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33298
STATE BOARD OF PHARMACY LISENCE
TX
Enumeration date
06/22/2020
Last updated
06/22/2020
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