Healthcare Provider Details
I. General information
NPI: 1972617967
Provider Name (Legal Business Name): HOUSTON MEDICINE CHEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2006
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 BRISBANE ST
HOUSTON TX
77061-5001
US
IV. Provider business mailing address
3160 PARK CENTER DR
TYLER TX
75701-8482
US
V. Phone/Fax
- Phone: 281-464-6300
- Fax: 903-885-1024
- Phone: 903-630-6000
- Fax: 903-594-4065
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 24968 |
| License Number State | TX |
VIII. Authorized Official
Name:
CHAD
MICHEL
Title or Position: CEO
Credential:
Phone: 903-630-6000