Healthcare Provider Details

I. General information

NPI: 1659889160
Provider Name (Legal Business Name): PHARM HOUSE CARRIZO SPRINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3531 TOWN CENTER BLVD S STE 103
SUGAR LAND TX
77479-2591
US

IV. Provider business mailing address

3531 TOWN CENTER BLVD S STE 103
SUGAR LAND TX
77479-2591
US

V. Phone/Fax

Practice location:
  • Phone: 832-876-2516
  • Fax:
Mailing address:
  • Phone: 844-843-0101
  • Fax: 844-843-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number31759
License Number StateTX

VIII. Authorized Official

Name: SANDRA L SCOTT
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 832-454-2848