Provider Demographics
NPI:1336634385
Name:SPRING BRANCH PHARMACY, LLC
Entity Type:Organization
Organization Name:SPRING BRANCH PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:830-885-7770
Mailing Address - Street 1:PO BOX 1232
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-1232
Mailing Address - Country:US
Mailing Address - Phone:830-885-7770
Mailing Address - Fax:
Practice Address - Street 1:17130 HIGHWAY 46 W STE 1
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-7093
Practice Address - Country:US
Practice Address - Phone:830-885-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321283336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy