Provider Demographics
NPI:1356462816
Name:CANTEX CONTINUING CARE NETWORK LLC
Entity Type:Organization
Organization Name:CANTEX CONTINUING CARE NETWORK LLC
Other - Org Name:PHARMACARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:LAKEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-320-2424
Mailing Address - Street 1:16750 WESTGROVE DR STE 100
Mailing Address - Street 2:DALLAS PHARMACY
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-5624
Mailing Address - Country:US
Mailing Address - Phone:972-620-6048
Mailing Address - Fax:972-620-9145
Practice Address - Street 1:16750 WESTGROVE DR STE 100
Practice Address - Street 2:DALLAS PHARMACY
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-5624
Practice Address - Country:US
Practice Address - Phone:972-620-6048
Practice Address - Fax:972-620-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX208513336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350133Medicaid
2091973OtherPK