Provider Demographics
NPI:1578605952
Name:TEXAS A&M UNIVERSITY
Entity Type:Organization
Organization Name:TEXAS A&M UNIVERSITY
Other - Org Name:AP BEUTEL HEALTH CENTER PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEKAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:979-458-8299
Mailing Address - Street 1:TEXAS A M UNIVERSITY
Mailing Address - Street 2:1264 TAMU PHARMACY
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77843-1264
Mailing Address - Country:US
Mailing Address - Phone:979-458-8292
Mailing Address - Fax:979-458-8294
Practice Address - Street 1:TEXAS A M UNIVERSITY
Practice Address - Street 2:1264 TAMU
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-1264
Practice Address - Country:US
Practice Address - Phone:979-458-8292
Practice Address - Fax:979-458-8294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS A&M UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX060153336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX06015OtherSTATE LICENSE NUMBER
TX00028674OtherDPS REGISTRATION
TX00028674OtherDPS REGISTRATION