Organization Active NPI

Mca Pharmacy, LLC

  • Pharmacy
  • Katy, TX
National Provider Identifier
1104167774
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
28466 Issued in TX
Legal business name
MCA PHARMACY, LLC
Practice address
21820 Katy Fwy Ste 110
Katy, TX 77449
Phone
(713) 373-3300
NPI assigned
Mar 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Koon, PHARMDNPI 1205134491
Title
Director of Pharmacy
Phone
(713) 373-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 28466 TX Primary

Addresses

Primary practice location

21820 Katy Fwy Ste 110
Katy, TX 77449

Mailing address

9055 Katy Fwy Ste 424
Houston, TX 77024-1624

Other identifiers 1

IdentifierTypeStateIssuer
149394MedicaidTX

Other names 1

  • Village Medical Pharmacy #2 Doing business as

National Provider Directory

National Provider Directory

Locations

9055 Katy Fwy
Ste 424
Houston, TX 77024

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1104167774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 KATY FWY STE 424",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21820 KATY FWY STE 110",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77449",
            "telephone_number": "713-373-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCA PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "KOON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "713-373-3300",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "28466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149394",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Medical Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Medical Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.