Healthcare Provider Details

I. General information

NPI: 1174609994
Provider Name (Legal Business Name): TEXANS PEOPLE PHARMACY AND WELLNESS CTR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6609 W SAM HOUSTON PKWY S STE 98B
HOUSTON TX
77072
US

IV. Provider business mailing address

6609 W SAM HOUSTON PKWY S STE 98B
HOUSTON TX
77072-1641
US

V. Phone/Fax

Practice location:
  • Phone: 713-995-8885
  • Fax: 713-776-9990
Mailing address:
  • Phone: 713-995-8885
  • Fax: 713-776-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number29154
License Number StateTX

VIII. Authorized Official

Name: BRYAN PHAN
Title or Position: MEMBER MANAGED
Credential: RPH
Phone: 713-995-8885