Provider Demographics
NPI:1770666968
Name:TCC INC DBA SENIORX LTC
Entity Type:Organization
Organization Name:TCC INC DBA SENIORX LTC
Other - Org Name:SENIORX LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARM
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-485-3282
Mailing Address - Street 1:3536 E BROADWAY ST
Mailing Address - Street 2:STE 104
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3536 E BROADWAY ST
Practice Address - Street 2:STE 104
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4307
Practice Address - Country:US
Practice Address - Phone:281-485-3282
Practice Address - Fax:281-485-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X, 3336L0003X, 3336M0002X, 3336M0003X
TX12485333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Not Answered3336M0002XSuppliersPharmacyMail Order Pharmacy
Not Answered3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4537013OtherOTHER ID NUMBER-COMMERCIAL NUMBER
TX143135Medicaid
0823190001Medicare ID - Type Unspecified