| NPI | 1134626997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | URSULA C HENRY Pharmacy Network Manager 281-776-3854 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 31744) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |