NPIMap

Organization Active NPI

Memorial Hermann Medical Group

Doing business as South Texas Pharmacy

  • Community/Retail Pharmacy
  • Wharton, TX
National Provider Identifier
1447392154
Registry record updated Oct 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
11855 Issued in TX
Legal business name
MEMORIAL HERMANN MEDICAL GROUP
Doing business as
South Texas Pharmacy
Practice address
2100 Regional Medical Dr
Wharton, TX 77488-9719
Phone
(979) 532-4910
Fax
(979) 532-6786
NPI assigned
Feb 12, 2007
Last updated
Oct 6, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HERMANN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2012

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

Authorized official

Name
Mr. William Perry Flowers, R.PH., M.S.
Title
System Executive PT Care Support
Phone
(979) 532-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 11855 TX Primary

Addresses

Primary practice location

2100 Regional Medical Dr
Wharton, TX 77488-9719

Mailing address

2100 Regional Medical Dr
Wharton, TX 77488-9719
Phone (979) 532-4910

Other identifiers 2

IdentifierTypeStateIssuer
4573158OtherNABP
142995MedicaidTX

Other names 1

  • SOUTH TEXAS PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Geriatric Resource Cent63 organizations share this tax ID, including this one
Part of
Geriatric Resource Cent

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349481600000",
    "number": "1447392154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 REGIONAL MEDICAL DR",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774889719",
            "telephone_number": "979-532-4910",
            "fax_number": "979-532-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 REGIONAL MEDICAL DR",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774889719",
            "telephone_number": "979-532-4910",
            "fax_number": "979-532-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HERMANN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HERMANN MEDICAL GROUP",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-10-06",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "SYSTEM EXECUTIVE PT CARE SUPPORT",
        "authorized_official_telephone_number": "979-532-1700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH., M.S."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "11855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4573158",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142995",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH TEXAS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wharton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2012; 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.