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General NPI Number Information
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NPI Number | 1326176082
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Entity Type | Organization
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Legal Business Name | PAULS HOUSE OF GENERIC PHARMACY
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 2302 45TH ST SUITE 1
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City | GALVESTON
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State | TX
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Zip | 77550-7399
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Country | US
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Telephone | 409-762-8959
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Fax | 409-763-4285
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Provider Business Mailing Address
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Address Line | 2302 45TH ST SUITE 1
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City | GALVESTON
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State | TX
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Zip | 77550-7399
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL BORSELLINI
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Credential | PHR
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Telephone | 409-762-8959
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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 | TX04963
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License Number State | TX
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