Healthcare Provider Details

I. General information

NPI: 1467811042
Provider Name (Legal Business Name): ECURB SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2503 S MAIN ST STE O
STAFFORD TX
77477-5544
US

IV. Provider business mailing address

2503 S MAIN ST UNIT O
STAFFORD TX
77477-5544
US

V. Phone/Fax

Practice location:
  • Phone: 281-969-7943
  • Fax: 281-969-7943
Mailing address:
  • Phone: 281-969-7943
  • Fax: 281-969-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number30390
License Number StateTX

VIII. Authorized Official

Name: ANTIONETTE HOLMES
Title or Position: OWNER
Credential:
Phone: 281-969-7943