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Contact Information

BOYLES BANDERA PHARMACY
1200 SYCAMORE ST
BANDERA, TX78003-2020
 Phone: 830-796-8191
 Fax: 830-796-8204
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for BOYLES BANDERA PHARMACY

NPI Number 1013010156
LBN Legal business name BOYLES BANDERA PHARMACY
Authorized official ROBERT MULLINS - (PIC PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/06/2006
Last updated 02/12/2010 - About 16 years ago
Identifiers
TX License # 12543
TX Medicaid 143183
Other 4569868 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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