Provider Demographics
NPI:1033155049
Name:ONCOLOGY PHARMACY SERVICES
Entity Type:Organization
Organization Name:ONCOLOGY PHARMACY SERVICES
Other - Org Name:TEXAS ONCOLOGY PHARMACY HEB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-490-2912
Mailing Address - Street 1:PO BOX 731145
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1145
Mailing Address - Country:US
Mailing Address - Phone:972-997-8103
Mailing Address - Fax:469-467-2535
Practice Address - Street 1:1609 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6920
Practice Address - Country:US
Practice Address - Phone:817-359-9070
Practice Address - Fax:817-359-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20166333600000X
3336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350154OtherTX VENDOR DRUG
TX20166OtherCLASS A LICENSE
TX4593465OtherNCPDP
TX068873101Medicaid
TX350154OtherTX VENDOR DRUG