Pharmara Labs LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

PHARMARA LABS LLC

Practice address

1511 Justin Rd Ste 106a
Lewisville, TX 75077-2196

Phone

(469) 946-6690

Fax

(469) 946-6691

NPI assigned

Sep 4, 2020

Organization subpart

No

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

Authorized official

Name

Tabraiz M Khan, PHARMD

Title

Manager

Phone

(908) 797-2080

Specialties & licenses 1

Addresses

Other names 1

• Formulation Compounding Center Doing business as

Locations

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1194339341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 JUSTIN RD STE 106A",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772196",
            "telephone_number": "469-946-6690",
            "fax_number": "469-946-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 JUSTIN RD STE 106A",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772196",
            "telephone_number": "469-946-6690",
            "fax_number": "469-946-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMARA LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "TABRAIZ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "908-797-2080",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Formulation Compounding Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Formulation Compounding Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nikki Minh Pham, PT
• Tiffany Lan Pham
• Tony Pham, RPH
• Trinh L. Pham, NP-C
• Cindy Phan
• Blessy Philip, O.D.
• Gibi Philip
• Justin Philip, DMD
• Sindhu E Philip, DO
• Ron Philipose, FNP

• Compounding Pharmacy in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Compounding Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.