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General NPI Number Information
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NPI Number | 1164889788
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Entity Type | Organization
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Legal Business Name | LA RX
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 3744 BROADWAY ST STE C
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City | HOUSTON
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State | TX
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Zip | 77017-3046
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Country | US
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Telephone | 832-426-4616
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Fax | 346-571-6998
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Provider Business Mailing Address
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Address Line | 589 S HAMPTON LN
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City | LEAGUE CITY
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State | TX
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Zip | 77573
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Country | US
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Telephone | 832-800-0190
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | TRINH NGUYEN
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Credential |
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Telephone | 832-800-0190
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 30388
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License Number State | TX
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