Provider Demographics
NPI:1760847560
Name:TEXAS CAPITAL PHARMACEUTICAL LLC
Entity Type:Organization
Organization Name:TEXAS CAPITAL PHARMACEUTICAL LLC
Other - Org Name:LAMAR FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOC
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:512-351-5890
Mailing Address - Street 1:8738 N LAMAR BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5418
Mailing Address - Country:US
Mailing Address - Phone:512-765-5831
Mailing Address - Fax:512-832-4744
Practice Address - Street 1:8738 N LAMAR BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-5424
Practice Address - Country:US
Practice Address - Phone:512-765-5831
Practice Address - Fax:512-832-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX303593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149319Medicaid