Palace Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28183 Issued in TX

Legal business name

PALACE PHARMACY LLC

Practice address

5200 Colleyville Blvd Ste C
Colleyville, TX 76034-5828

Phone

(817) 599-7988

Fax

(800) 419-2801

NPI assigned

Aug 17, 2012

Organization subpart

No

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

Authorized official

Name

Spencer Malkin

Title

Corporate Member

Phone

(561) 404-8885

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Medicine Box Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1457609752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COLLEYVILLE BLVD STE C",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345828",
            "telephone_number": "817-599-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 COLLEYVILLE BLVD STE C",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345828",
            "telephone_number": "817-599-7988",
            "fax_number": "800-419-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALACE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "MALKIN",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "CORPORATE MEMBER",
        "authorized_official_telephone_number": "561-404-8885"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28183",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136637",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Box Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dennis L Ortiz, DO
• Nicholas Overbeck, LPC
• Mandy Daniell Ozuna, LPC
• Kathleen Pace, D.D.S.
• Natalie Pachinger
• Palmercare Chiropractic Colleyville LLC
• Kimberly V Para, LPC
• Alan Paradis, D.D.S., F.A.C.P
• Juno Park, DDS, MS
• Helen Nicole Parker, LPC, CRC

• Community/Retail Pharmacy in Colleyville, TX
• Providers in Colleyville, 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 Dec 3, 2015; 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.