Healthcare Provider Details

I. General information

NPI: 1093378366
Provider Name (Legal Business Name): DELIVERIT PHARMACY CLEAR LAKE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N KOBAYASHI STE 113
WEBSTER TX
77598-4840
US

IV. Provider business mailing address

12144 DAIRY ASHFORD RD STE 100
SUGAR LAND TX
77478-6212
US

V. Phone/Fax

Practice location:
  • Phone: 281-724-4828
  • Fax: 281-724-4826
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EHAB M ABUGHAZALEH
Title or Position: CEO
Credential:
Phone: 713-562-6775