FM 1488 Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FM 1488 PHARMACY LLC

Practice address

4849 FM 1488 Rd Ste 1500
The Woodlands, TX 77354-4560

Phone

(281) 864-1184

Fax

(281) 864-1191

NPI assigned

Jul 13, 2022

Organization subpart

No

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

Authorized official

Name

Prachi K Patel

Title

Managing Officer/Owner

Phone

(281) 864-1184

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• FM 1488 PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

FM 1488 Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• FM 1488 Pharmacy LLC

  • Clinic/Center
  • Magnolia, TX
  • NPI 1073323028
  NPD tax ID

Practitioners 1

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

• Krunal Babubhai Patel, PHARM.D.

  • Pharmacist
  • The Woodlands, TX
  • NPI 1538448170
  NPD

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1356075469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 FM 1488 RD STE 1500",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773544560",
            "telephone_number": "281-864-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 FM 1488 RD STE 1500",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773544560",
            "telephone_number": "281-864-1184",
            "fax_number": "281-864-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FM 1488 PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRACHI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING OFFICER/OWNER",
        "authorized_official_telephone_number": "281-864-1184"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150562",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FM 1488 PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FM 1488 PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serena Flores, LPC-S
• Flow Physical Therapy and Wellness PLLC
• Neville Brian Flowers, M.D.
• Tracey Bess Flowers, LPC-S NCE
• Alexis Dawn Flynt
• Focus Optical LLC
• Borel Sedimee Fonhoue, M.D.
• Amanda Troyer Fontenot, AU.D.
• Anne Fontenot, PTA
• Catherine Alexis Fontenot, PA-C

• Community/Retail Pharmacy in The Woodlands, TX
• Providers in The Woodlands, 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 Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.