Healthcare Provider Details

I. General information

NPI: 1962040436
Provider Name (Legal Business Name): QUEENSLAND ENTERPRISES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7909 W GRAND PKWY S STE 215
RICHMOND TX
77407-8648
US

IV. Provider business mailing address

7909 W GRAND PKWY S STE 215
RICHMOND TX
77407-8648
US

V. Phone/Fax

Practice location:
  • Phone: 281-762-7130
  • Fax: 713-804-5046
Mailing address:
  • Phone: 281-762-7130
  • Fax: 713-804-5046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BERNARD THOMPSON
Title or Position: OWNER/PIC
Credential:
Phone: 281-762-7130