Provider Demographics
NPI:1437665551
Name:ONCOLOGY PHARMACY SERVICES INC.
Entity Type:Organization
Organization Name:ONCOLOGY PHARMACY SERVICES INC.
Other - Org Name:TEXAS ONCOLOGY PHARMACY WILLOWBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:BIVONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-997-8103
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 1:13215 DOTSON RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4535
Practice Address - Country:US
Practice Address - Phone:832-996-4029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317393336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31739OtherTEXAS STATE BOARD OF PHARMACY