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General NPI Number Information
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NPI Number | 1356652713
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Entity Type | Organization
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Legal Business Name | WEST HOUSTON SPECIALTY PHARMACY
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 12579 RICHMOND AVE SUITE 300A
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City | HOUSTON
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State | TX
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Zip | 77082-2552
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Country | US
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Telephone | 281-556-9477
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Fax | 281-558-8505
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Provider Business Mailing Address
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Address Line | 12579 RICHMOND AVE SUITE 300A
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City | HOUSTON
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State | TX
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Zip | 77082-2552
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Country | US
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Telephone | 281-556-9477
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Fax | 281-558-8505
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. KHANDOKER RAFIQUL HAQUE
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Credential | RPH
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Telephone | 281-691-0419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 26939
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License Number State | TX
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