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General NPI Number Information
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NPI Number | 1346290350
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Entity Type | Organization
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Legal Business Name | CMG PHARMACY LLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 11040 EAST FWY STE 200
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City | HOUSTON
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State | TX
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Zip | 77029-1931
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Country | US
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Telephone | 713-451-6681
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Fax | 713-451-6818
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Provider Business Mailing Address
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Address Line | 11040 EAST FWY STE 200
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City | HOUSTON
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State | TX
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Zip | 77029-1931
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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 | PRESIDENT
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Name | D. ARMANDO CHAVEZ
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Credential |
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Telephone | 713-451-5935
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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 | 24992
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License Number State | TX
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