Provider Demographics
NPI:1649216516
Name:ONCOLOGY PHARMACY SERVICES, INC
Entity Type:Organization
Organization Name:ONCOLOGY PHARMACY SERVICES, INC
Other - Org Name:TEXAS ONCOLOGY PHARMACY AUSTIN CENTRAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-490-2912
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 1:6204 BALCONES DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4214
Practice Address - Country:US
Practice Address - Phone:512-427-9448
Practice Address - Fax:512-302-3928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20165333600000X
3336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20165OtherCLASS A LIC
TX068868101Medicaid
TX350148OtherHHSC VENDOR
TX4592386OtherNCPDP
TX20165OtherCLASS A LIC