Organization Active NPI

Oben Pharmacy Group LLC

Doing business as GoldStar Long Term Care

  • Long Term Care Pharmacy
  • Bryan, TX
National Provider Identifier
1952849309
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
31590 Issued in TX
Legal business name
OBEN PHARMACY GROUP LLC
Doing business as
GoldStar Long Term Care
Practice address
4500 Carter Creek Pkwy Ste 202
Bryan, TX 77802-4494
Phone
(844) 465-3582
Fax
(855) 201-8501
NPI assigned
Feb 6, 2017
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Bessem Oben
Title
Pharmacy Manager
Phone
(832) 235-0807

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 31590 TX Primary

Addresses

Primary practice location

4500 Carter Creek Pkwy Ste 202
Bryan, TX 77802-4494

Mailing address

4500 Carter Creek Pkwy
Suite 203
Bryan, TX 77802-4494
Phone (844) 465-3582

Other identifiers 1

IdentifierTypeStateIssuer
2172246OtherPK

Other names 1

  • GoldStar Long Term Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160818001127 TX Part B Supplier - Pharmacy 3870888605 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bryan, TX; College Station, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4500 Carter Creek Pkwy
Ste 202
Bryan, TX 77802
Phone (844) 465-3582

4500 Carter Creek Pkwy
Ste 203
Bryan, TX 77802

4421 State Highway 6 S
Ste 300
College Station, TX 77845
Phone (979) 330-5216

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1952849309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 CARTER CREEK PKWY",
            "address_2": "SUITE 203",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024494",
            "telephone_number": "844-465-3582",
            "fax_number": "855-201-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 CARTER CREEK PKWY STE 202",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024494",
            "telephone_number": "844-465-3582",
            "fax_number": "855-201-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBEN PHARMACY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "OBEN",
        "authorized_official_first_name": "BESSEM",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "832-235-0807"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "31590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2172246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GoldStar Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GoldStar Long Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.