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MIRA VISTA PHARMACY PLLC NPI 1801107123


NPI Information

NPI: 1801107123
Provider Name: MIRA VISTA PHARMACY PLLC

Doing Business As: MIRA VISTA APOTHECARY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
7033 BRYANT IRVIN RD
FORT WORTH, TX
ZIP 76132
Phone: (817) 292-3800
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MIRA VISTA PHARMACY PLLC is a community/retail pharmacy pharmacy in Fort Worth, TX. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MIRA VISTA PHARMACY PLLC NPI is 1801107123. The provider is registered as an organization entity type.
The provider Is Doing Business As Mira Vista Apothecary.

The provider's business location address is:

7033 BRYANT IRVIN RD
FORT WORTH, TX
ZIP 76132-243
Phone: (817) 292-3800
Fax: (817) 292-3810

The provider's authorized official is Moni Sagoo .
The authorized official title is Director Of Pharmacy and has the following contact phone number (817) 292-3800.

The enumeration date for this NPI number is 7/1/2010 and was last updated on 7/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0004XPharmacyCompounding PharmacyNo
43336S0011XPharmacySpecialty PharmacyNo
53336C0003XPharmacyCommunity/Retail Pharmacy26982TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12125635OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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