Provider Demographics
NPI:1912199381
Name:IV & HOME HEALTH SERVICES OF TEXAS
Entity Type:Organization
Organization Name:IV & HOME HEALTH SERVICES OF TEXAS
Other - Org Name:PHARMACY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PHARMACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPECIALISTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-426-7006
Mailing Address - Street 1:2140 JUSTIN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7163
Mailing Address - Country:US
Mailing Address - Phone:972-426-7006
Mailing Address - Fax:972-426-7007
Practice Address - Street 1:2140 JUSTIN RD STE 100
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7163
Practice Address - Country:US
Practice Address - Phone:972-426-7006
Practice Address - Fax:972-426-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X
IN64002032A3336S0011X
GAPHNR0006913336S0011X
MO20150162353336S0011X
IA47843336S0011X
AROS025593336S0011X
CTPCN.00030183336S0011X
MN2652263336S0011X
NMPH000038013336S0011X
LAPHY.006934-NR3336S0011X
NC127843336S0011X
KS22-448163336S0011X
ILO540194533336S0011X
MTPHA-MOP-LIC-469983336S0011X
NY341673336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2144503OtherPK
TX360138701Medicaid
6006710001Medicare NSC