Provider Demographics
NPI:1013048941
Name:HALLS IV & INSTITUTIONAL PHARMACY DBA XPRESS COMPOUNDING PHARMACY
Entity Type:Organization
Organization Name:HALLS IV & INSTITUTIONAL PHARMACY DBA XPRESS COMPOUNDING PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:O
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:866-405-0432
Mailing Address - Street 1:1000 WEATHERFORD ST.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102
Mailing Address - Country:US
Mailing Address - Phone:817-207-0110
Mailing Address - Fax:844-207-0110
Practice Address - Street 1:1000 WEATHERFORD ST.
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102
Practice Address - Country:US
Practice Address - Phone:817-207-0110
Practice Address - Fax:844-207-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBH4081636OtherDEA