Healthcare Provider Details

I. General information

NPI: 1225037542
Provider Name (Legal Business Name): MAGDALENE VULKOVIC RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 OFFICE CITY DR PHARMACY
HOUSTON TX
77012-4115
US

IV. Provider business mailing address

7550 OFFICE CITY DR PHARMACY
HOUSTON TX
77012-4115
US

V. Phone/Fax

Practice location:
  • Phone: 713-495-3716
  • Fax: 713-495-3717
Mailing address:
  • Phone: 713-495-3716
  • Fax: 713-495-3717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24088
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: