Basic Information
| Provider Information | |||||||||
| NPI: | 1851656037 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALING INFECTIONS PHARMACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 920 MEDICAL PLAZA DR | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | SHENANDOAH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773803260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666291799 | ||||||||
| FaxNumber: | 9365399685 | ||||||||
| Practice Location | |||||||||
| Address1: | 920 MEDICAL PLAZA DR | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | SHENANDOAH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773803260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666291799 | ||||||||
| FaxNumber: | 9365399685 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2012 | ||||||||
| LastUpdateDate: | 07/12/2012 | ||||||||
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| AuthorizedOfficialLastName: | GILL | ||||||||
| AuthorizedOfficialFirstName: | SHAZIA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8666291799 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0002X | Y | Suppliers | Pharmacy | Clinic Pharmacy |
No ID Information.