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General NPI Number Information
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NPI Number | 1396944179
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Entity Type | Organization
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Legal Business Name | PASADENA MEDICAL PLAZA PHARMACY
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 1430B PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77502
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Country | US
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Telephone | 713-429-1842
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Fax |
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Provider Business Mailing Address
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Address Line | 1430B PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77502
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Country | US
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Telephone | 713-429-1842
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. ANNICK RODRIGUEZ
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Credential |
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Telephone | 832-724-0065
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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 | 25624
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License Number State | TX
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