| NPI | 1811387673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL HENRIKSEN CEO 832-770-8194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.007064-IR) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-02 |