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General NPI Number Information
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NPI Number | 1518248376
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Entity Type | Organization
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Legal Business Name | CNC PHARMACY COMPOUNDING
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 15040 FAIRFIELD VILLAGE SQUARE DR STE 100
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City | CYPRESS
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State | TX
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Zip | 77433-7900
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Country | US
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Telephone | 281-758-4040
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Fax | 281-758-4043
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Provider Business Mailing Address
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Address Line | 15040 FAIRFIELD VILLAGE SQUARE DR STE 100
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City | CYPRESS
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State | TX
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Zip | 77433-7900
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Country | US
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Telephone | 281-758-4040
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Fax | 281-758-4043
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CHIEBONAM ONYEKWELU
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Credential | PHARMD
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Telephone | 281-827-4432
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 27661
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License Number State | TX
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