Infusion Services & Specialty Pharmacy

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

License

25430 Issued in TX

Legal business name

INFUSION SERVICES & SPECIALTY PHARMACY

Doing business as

ISRX Corporation

Practice address

1724 East Broad St.
Suite 136
Mansfield, TX 76063

Phone

(817) 453-5022

Fax

(817) 453-5027

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Marsha Lyn Proctor, PHAMD

Title

Pharmacist in Charge

Phone

(817) 937-0159

Specialties & licenses 8

Addresses

Other names 1

• ISRX Corporation Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manohar P Vajja, MD

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1306048277
  Medicare reassignment NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1932237534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 EAST BROAD ST.",
            "address_2": "SUITE 136",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-453-5022",
            "fax_number": "817-453-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 EAST BROAD ST.",
            "address_2": "SUITE 136",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-453-5022",
            "fax_number": "817-453-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFUSION SERVICES & SPECIALTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "817-937-0159",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHAMD"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Geriatric",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Nutrition Support",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "1835X0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Oncology",
            "state": "TX",
            "license": "25430",
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "TX",
            "license": "25430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ISRX Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Infusion Services & Specialty Pharmacy (ISRX Corporation)
• Infusion Services & Specialty Pharmacy (Isrx Corp)
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• Infusion Services & Specialty Pharmacy (ISRX Corporation)
• James W Ingram, DPT
• Innate's Touch Chiropractic
• Innerquest Psychiatry PLLC
• Integration Group Home LLC

• Infusion Therapy Clinic/Center in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Infusion Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.