| NPI | 1205534039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY SMITH Credentialing COO Rdinator Ii 281-824-1480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2024-03-26 |