Provider Demographics
NPI:1821151382
Name:COOGS INVESTMENTS LTD
Entity Type:Organization
Organization Name:COOGS INVESTMENTS LTD
Other - Org Name:TYLER MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LADISLAO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-365-3217
Mailing Address - Street 1:1002 E TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7136
Mailing Address - Country:US
Mailing Address - Phone:956-365-3217
Mailing Address - Fax:956-421-2135
Practice Address - Street 1:1002 E TYLER AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7136
Practice Address - Country:US
Practice Address - Phone:956-365-3217
Practice Address - Fax:956-421-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4543496OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX145750Medicaid
TX145750Medicaid