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General NPI Number Information
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NPI Number | 1093181760
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Entity Type | Organization
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Legal Business Name | CARECO PHARMACY LLC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 15003 FM 529 RD STE H
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City | HOUSTON
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State | TX
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Zip | 77095-3247
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Country | US
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Telephone | 832-803-0388
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Fax | 832-683-4983
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Provider Business Mailing Address
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Address Line | 15003 FM 529 RD SUITE H
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City | HOUSTON
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State | TX
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Zip | 77095-3247
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Country | US
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Telephone | 832-803-0388
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Fax | 832-683-4983
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Authorized Official
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Title or Position | CO-OWNER
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Name | ANGELA LE
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Credential |
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Telephone | 832-803-0388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 30134
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License Number State | TX
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