Prestige Worldwide Pharma LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

PRESTIGE WORLDWIDE PHARMA LLC

Doing business as

Hill Country Specialty Pharmacy

Practice address

1430 S Main St Ste 105
Boerne, TX 78006-3334

Phone

(830) 224-0090

Fax

(830) 224-0095

NPI assigned

Aug 2, 2024

Organization subpart

No

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

Authorized official

Name

Dudley Iles Klatt II, PHARM.D.

Title

Officer

Phone

(361) 227-0412

Specialties & licenses 1

Addresses

Other names 1

• Hill Country Specialty Pharmacy Doing business as

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1811727159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 S MAIN ST STE 105",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063334",
            "telephone_number": "830-224-0090",
            "fax_number": "830-224-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 S MAIN ST STE 105",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063334",
            "telephone_number": "830-224-0090",
            "fax_number": "830-224-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE WORLDWIDE PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "KLATT",
        "authorized_official_first_name": "DUDLEY",
        "authorized_official_middle_name": "ILES",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "361-227-0412",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hill Country Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.