| NPI | 1255051900 |
|---|---|
| Doing Business As | KATY TRAIL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL WALLER CEO 660-310-0809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2024-02-21 |