=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245565191
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | L AND B PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2009
-----------------------------------------------------
Last Update Date | 12/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8103 CREEKBEND DR STE G
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77071-1555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-773-2996
-----------------------------------------------------
Fax | 832-804-7655
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8103 CREEKBEND DR STE G
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77071-1555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-773-2996
-----------------------------------------------------
Fax | 832-804-7655
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BINTA BARRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-773-2996
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 26963
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------