Provider Demographics
NPI:1033267042
Name:TEXAS PARKWAY PHARMACY
Entity Type:Organization
Organization Name:TEXAS PARKWAY PHARMACY
Other - Org Name:TEXAS PARKWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELISITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-863-3900
Mailing Address - Street 1:1110 FM 2234 RD
Mailing Address - Street 2:STE 200
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6483
Mailing Address - Country:US
Mailing Address - Phone:281-208-1346
Mailing Address - Fax:281-208-1942
Practice Address - Street 1:1110 FM 2234 RD
Practice Address - Street 2:STE 200
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6483
Practice Address - Country:US
Practice Address - Phone:281-208-1346
Practice Address - Fax:281-208-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX262803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4543713OtherNCPDP PROVIDER IDENTIFICATION NUMBER