Provider Demographics
NPI:1245030519
Name:MISTER MEDS LLC
Entity type:Organization
Organization Name:MISTER MEDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:TABRAUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-295-1084
Mailing Address - Street 1:141 CLYDE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-1751
Mailing Address - Country:US
Mailing Address - Phone:866-676-3371
Mailing Address - Fax:866-611-9114
Practice Address - Street 1:141 CLYDE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-1751
Practice Address - Country:US
Practice Address - Phone:866-676-3371
Practice Address - Fax:866-611-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX35657OtherTEXAS STATE BOARD OF PHARMACY