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NPI Code Detail

MEDICARE: EDNA G HOUSTON RPH

MEDICARE: EDNA G HOUSTON RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist17494TX

General Provider Information

NPI Number : 1386965465
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDNA G HOUSTON RPH
Provider Business Mailing Address
First Line : 1301 BANKS ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-6015
Country : US
Telephone Number : 713-529-2104
Fax Number : 713-664-2342
Provider Business Practice Location Address
First Line : 5225 BUFFALO SPEEDWAY
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4210
Country : US
Telephone Number : 713-218-1850
Fax Number : 713-664-2342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2010
Last Update Date : 06/12/2010

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