1437665551 NPI number — ONCOLOGY PHARMACY SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437665551 NPI number — ONCOLOGY PHARMACY SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOLOGY PHARMACY SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TEXAS ONCOLOGY PHARMACY WILLOWBROOK
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437665551
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 731145
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75373-1145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-997-8103
Provider Business Mailing Address Fax Number:
469-467-2535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13215 DOTSON RD STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77070-4535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-996-4029
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BIVONA
Authorized Official First Name:
TODD
Authorized Official Middle Name:
KEVIN
Authorized Official Title or Position:
REVENUE CYCLE MANAGER
Authorized Official Telephone Number:
972-997-8103

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  31739 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 31739 . This is a "TEXAS STATE BOARD OF PHARMACY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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