Bandera Apothecary LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

18620 Issued in TX

Legal business name

BANDERA APOTHECARY LP

Doing business as

ReNue Pharmacy
ReNue RX #6

Practice address

2270 Springlake Rd # 800B
Farmers Branch, TX 75234-5872

Phone

(210) 802-0511

Fax

(210) 802-0512

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Raj Milan Chhadua, PHARMD

Title

Owner/Managing Partner

Phone

(214) 422-2598

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 3

• ReNue Pharmacy Doing business as
• ReNue RX #6 Doing business as
• NetCare Pharmacy #1 Other name

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1104990639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2735",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750340051",
            "telephone_number": "469-294-2001",
            "fax_number": "210-256-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 SPRINGLAKE RD # 800B",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752345872",
            "telephone_number": "210-802-0511",
            "fax_number": "210-802-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANDERA APOTHECARY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "CHHADUA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_middle_name": "MILAN",
        "authorized_official_title_or_position": "OWNER/MANAGING PARTNER",
        "authorized_official_telephone_number": "214-422-2598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "18620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2090498",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "752368",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144664",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ReNue Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ReNue RX #6",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NetCare Pharmacy #1",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Retail Pharmacy in Farmers Branch, TX
• Providers in Farmers Branch, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.