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General NPI Number Information
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NPI Number | 1265676613
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Entity Type | Organization
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Legal Business Name | HOUSTON MIDTOWN PHARMACY LLC
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 6609 W SAM HOUSTON PKWY S STE 98
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City | HOUSTON
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State | TX
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Zip | 77072-1640
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Country | US
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Telephone | 832-831-0346
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Fax | 832-831-0390
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Provider Business Mailing Address
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Address Line | 6609 W SAM HOUSTON PKWY S STE 98
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City | HOUSTON
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State | TX
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Zip | 77072-1640
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Country | US
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Telephone | 832-831-0346
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Fax | 832-831-0390
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Authorized Official
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Title or Position | AO
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Name | MICHAEL MOORE
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Credential |
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Telephone | 832-265-4614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26529
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License Number State | TX
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