NPI age
19 years
Enumerated 2006-11-15
Across 5625 active pharmacy providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 1366515835 | NPI |
| 01 (TX) | PH0342 | MEDICARE IMMUNIZATION BILLING--TRAILBLAZER |
| 01 | 4592463 | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 01 (TX) | DMEH29026 | TMHP MEDICARE CROSSOVER TO TX MEDICAID |
| 01 (TX) | 16076 | TX STATE BOARD OF PHARMACY LICENSE |
| 05 (TX) | 463949 | |
| 01 (TX) | H0089621 | TX DPS |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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