Provider Demographics
NPI:1922174176
Name:PHARMA SELECT TEXAS LP
Entity Type:Organization
Organization Name:PHARMA SELECT TEXAS LP
Other - Org Name:PHARMA SELECT TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:NIZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-888-8099
Mailing Address - Street 1:5710 LBJ FWY
Mailing Address - Street 2:SUITE 325
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6324
Mailing Address - Country:US
Mailing Address - Phone:214-888-8099
Mailing Address - Fax:214-261-2217
Practice Address - Street 1:1535 WEST LOOP S
Practice Address - Street 2:SOUTH OFFICE BLDG, STE 319
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9512
Practice Address - Country:US
Practice Address - Phone:832-280-6330
Practice Address - Fax:844-631-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154861OtherPK