Jtac2 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

24218 Issued in TX

Legal business name

JTAC2 INC

Practice address

10019 S Main St # a-10
Houston, TX 77025-5209

Phone

(713) 667-5003

Fax

(713) 667-5030

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery K Williams, RPH

Title

President

Phone

(713) 667-5003

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Main Medical Plaza Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821152323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10019 S MAIN ST # A-10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255209",
            "telephone_number": "713-667-5003",
            "fax_number": "713-667-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10019 S MAIN ST # A-10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255209",
            "telephone_number": "713-667-5003",
            "fax_number": "713-667-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JTAC2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-667-5003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "24218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145582",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Medical Plaza Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, 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 Aug 22, 2020; 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.