| NPI | 1114276540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMIAN MAGEE Pharmacist In Charge 281-402-3960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: 28169) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: 28169) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-08-30 |