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General NPI Number Information
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NPI Number | 1124387386
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Entity Type | Organization
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Legal Business Name | ECO PHARMACY OF WILLOWBROOK, LLC
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 13325 HARGRAVE RD STE 260
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City | HOUSTON
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State | TX
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Zip | 77070-4539
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Country | US
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Telephone | 281-955-7500
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Fax | 281-955-7504
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Provider Business Mailing Address
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Address Line | 5714 SANTA FE SPRINGS DR
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City | HOUSTON
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State | TX
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Zip | 77041-5755
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Country | US
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Telephone | 832-859-9523
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | JASMEET SINGH
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Credential |
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Telephone | 832-859-9523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28031
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License Number State | TX
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