Provider Demographics
NPI:1215044912
Name:TCJ LEASING INC
Entity Type:Organization
Organization Name:TCJ LEASING INC
Other - Org Name:CAPROCK PHARMACY SLATON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-792-2713
Mailing Address - Street 1:165 S 9TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SLATON
Mailing Address - State:TX
Mailing Address - Zip Code:79364-4121
Mailing Address - Country:US
Mailing Address - Phone:806-828-6590
Mailing Address - Fax:806-828-6593
Practice Address - Street 1:165 S 9TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:SLATON
Practice Address - State:TX
Practice Address - Zip Code:79364-4121
Practice Address - Country:US
Practice Address - Phone:806-828-6590
Practice Address - Fax:806-828-6593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX243383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4526123OtherNABP
TX145580Medicaid
TX24338OtherPHARMACY LICENSE NUMBER
TXBC9497973OtherDEA REGISTRATION
TX145580Medicaid