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General NPI Number Information
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NPI Number | 1194057299
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Entity Type | Organization
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Legal Business Name | SELF CHOICE MEDICAL SUPPLIES & EQUIPMENT
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 6055 BISSONNET ST STE C
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City | HOUSTON
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State | TX
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Zip | 77081-6965
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Country | US
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Telephone | 713-664-1555
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Fax | 713-644-1556
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Provider Business Mailing Address
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Address Line | 6055 BISSONNET ST STE C
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City | HOUSTON
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State | TX
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Zip | 77081-6965
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Country | US
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Telephone | 713-664-1555
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Fax | 713-644-1556
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. GUISELLY CANTU
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Credential |
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Telephone | 713-664-1555
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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 | 26742
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License Number State | TX
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