Provider Demographics
NPI:1568473056
Name:OAK HILLS MEDICAL BUILDING PHCY INC
Entity Type:Organization
Organization Name:OAK HILLS MEDICAL BUILDING PHCY INC
Other - Org Name:OAK HILLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:210-614-4100
Mailing Address - Street 1:7711 LOUIS PASTEUR DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3411
Mailing Address - Country:US
Mailing Address - Phone:210-614-4100
Mailing Address - Fax:210-614-7723
Practice Address - Street 1:7711 LOUIS PASTEUR DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3411
Practice Address - Country:US
Practice Address - Phone:210-614-4100
Practice Address - Fax:210-614-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX58743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144520Medicaid
2102514OtherPK
TX144520Medicaid