| NPI | 1720193766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA FOMUNUNG Dir Of Phrmcy 832-328-1855 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 21402) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-10-08 |