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General NPI Number Information
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NPI Number | 1255996971
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Entity Type | Organization
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Legal Business Name | 1ST EXPRESS PHARMACY LLC
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 24420 FM 1314 RD STE 13
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City | PORTER
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State | TX
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Zip | 77365-5490
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Country | US
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Telephone | 281-747-7158
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Fax | 281-747-7172
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Provider Business Mailing Address
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Address Line | 24420 FM 1314 RD STE 13
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City | PORTER
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State | TX
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Zip | 77365-5490
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Country | US
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Telephone | 281-747-7158
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Fax | 281-747-7172
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Authorized Official
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Title or Position | MANAGER
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Name | DEIDRA SHERMAN
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Credential |
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Telephone | 281-747-7158
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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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