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General NPI Number Information
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NPI Number | 1467556431
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Entity Type | Organization
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Legal Business Name | UM PHARMACY
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 963 FEDERAL RD
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City | HOUSTON
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State | TX
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Zip | 77015-4801
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Country | US
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Telephone | 713-453-5100
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Fax | 713-453-5101
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Provider Business Mailing Address
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Address Line | 963 FEDERAL RD
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City | HOUSTON
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State | TX
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Zip | 77015-4801
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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 | PIC
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Name | WENDELL J PAYNE
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Credential | RPH
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Telephone | 713-453-5100
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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 | 25071
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License Number State | TX
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