Mixlab TX, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MIXLAB TX, LLC

Practice address

953 Hilltop Dr
Weatherford, TX 76086-8811

Phone

(888) 901-4480

NPI assigned

Apr 26, 2024

Organization subpart

Yes

Parent organization

MIXLAB, INC.As reported in NPPES

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

Authorized official

Name

Vinnei Dam, PHARMD, MS

Title

Chief Pharmacy Officer

Phone

(347) 610-9820

Specialties & licenses 2

Addresses

Part of

Mixlab Inc

Locations

Practitioners 1

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

• Vinh Dam, PHARM.D.

  • Pharmacist
  • Bloomfield, NJ
  • NPI 1255640355
  NPD

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1245086552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 HILLTOP DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760868811",
            "telephone_number": "888-901-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 HILLTOP DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760868811",
            "telephone_number": "888-901-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIXLAB TX, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIXLAB, INC.",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "DAM",
        "authorized_official_first_name": "VINNEI",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "347-610-9820",
        "authorized_official_credential": "PHARMD, MS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Miller, O.D.
• Michael J Miller, CRNA
• Robert Michael Miller, MD
• Larry Ernest Mills, OT
• Shawna Anne Mitchell
• Modlife Counseling, LLC
• Metrah Mohammad Nader, MD
• Tannia Lorena Montiel, RN
• Valerie Moon, COTA
• Gwendalynn Rachel Moore

• Pharmacy in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.