Organization
TXEX MED LLC
Active
Other names
Johnson City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL LIETZ RPH (PHARMACIST/OWNER)
(830) 868-7185
Entity
Organization
Contact information
Practice address
405 HWY 281 SOUTH, JOHNSON CITY, TX 78636
(830) 868-7185
(830) 868-7183
Mailing address
PO BOX 433, JOHNSON CITY, TX 78636-0433
(830) 868-7185
(830) 868-7183
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28451
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140036
PK
—
Enumeration date
07/14/2009
Last updated
08/18/2016
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