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General NPI Number Information
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NPI Number | 1477712511
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Entity Type | Organization
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Legal Business Name | DIABETES CENTER OF AMERICA PHARMACY
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 7020 PORTWEST DR STE 130
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City | HOUSTON
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State | TX
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Zip | 77024-8040
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Country | US
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Telephone | 713-840-5165
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Fax | 713-862-3939
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Provider Business Mailing Address
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Address Line | 7020 PORTWEST DR STE 130
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City | HOUSTON
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State | TX
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Zip | 77024-8040
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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 | DIRECTOR OF PHARMACY
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Name | FELICIA CRAWFORD
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Credential | RPH PHARMD
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Telephone | 713-840-5165
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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 | 25279
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License Number State | TX
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