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General NPI Number Information
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NPI Number | 1467115220
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Entity Type | Organization
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Legal Business Name | EVEREST TC JESTER PHARMACY LLC
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 11626 T C JESTER BLVD # 700
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City | HOUSTON
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State | TX
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Zip | 77067-1322
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Country | US
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Telephone | 832-772-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 11626 T C JESTER BLVD # 700
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City | HOUSTON
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State | TX
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Zip | 77067-1322
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Country | US
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Telephone | 832-772-4100
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | RAYMOND TSANG
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Credential |
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Telephone | 832-772-4100
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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 |
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License Number State |
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