Provider Demographics
NPI:1891214524
Name:TEXAS PHARMACY MANAGEMENT GROUP LLC
Entity Type:Organization
Organization Name:TEXAS PHARMACY MANAGEMENT GROUP LLC
Other - Org Name:CLARX HUB CITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:806-749-6133
Mailing Address - Street 1:3716 22ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1312
Mailing Address - Country:US
Mailing Address - Phone:806-749-6133
Mailing Address - Fax:806-478-1429
Practice Address - Street 1:3716 22ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1312
Practice Address - Country:US
Practice Address - Phone:806-749-6133
Practice Address - Fax:325-305-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149863Medicaid