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General NPI Number Information
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NPI Number | 1104167774
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Entity Type | Organization
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Legal Business Name | MCA PHARMACY, LLC
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 21820 KATY FWY STE 110
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City | KATY
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State | TX
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Zip | 77449
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Country | US
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Telephone | 713-373-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 9055 KATY FWY STE 424
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City | HOUSTON
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State | TX
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Zip | 77024-1624
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DAVID KOON
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Credential | PHARMD
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Telephone | 713-373-3300
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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 | 28466
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License Number State | TX
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