Provider Demographics
NPI:1669918132
Name:TEXAS HEALTH MEDICAL SUPPORT
Entity type:Organization
Organization Name:TEXAS HEALTH MEDICAL SUPPORT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:RANDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-236-2550
Mailing Address - Street 1:600 E. LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 BRIDGEWOOD DR STE 107
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-0808
Practice Address - Country:US
Practice Address - Phone:682-236-2550
Practice Address - Fax:682-236-0051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS HEALTH RESOURCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies