Provider Demographics
NPI:1578634705
Name:APEX PHARMA LLC
Entity Type:Organization
Organization Name:APEX PHARMA LLC
Other - Org Name:APEX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING/AUTH OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NIZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-432-6550
Mailing Address - Street 1:5710 LBJ FWY
Mailing Address - Street 2:SUITE 190
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6324
Mailing Address - Country:US
Mailing Address - Phone:877-898-6915
Mailing Address - Fax:888-854-6704
Practice Address - Street 1:5710 LYNDON B JOHNSON FWY
Practice Address - Street 2:SUITE 190
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6324
Practice Address - Country:US
Practice Address - Phone:972-432-6550
Practice Address - Fax:888-854-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292313336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146469OtherPK
TX145604Medicaid
TX5678650001Medicare ID - Type Unspecified