Provider Demographics
NPI:1821367319
Name:FAMILY BIOCARE LLC
Entity type:Organization
Organization Name:FAMILY BIOCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-300-4490
Mailing Address - Street 1:4949 FAIRMONT PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3757
Mailing Address - Country:US
Mailing Address - Phone:832-900-7712
Mailing Address - Fax:281-991-1200
Practice Address - Street 1:4949 FAIRMONT PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3757
Practice Address - Country:US
Practice Address - Phone:832-900-7712
Practice Address - Fax:281-991-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX278253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5904796OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6685460001Medicare NSC