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General NPI Number Information
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NPI Number | 1518370808
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Entity Type | Organization
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Legal Business Name | TEXAS UNICARE PHARMACY LLC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 2424 W HOLCOMBE BLVD STE 101
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City | HOUSTON
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State | TX
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Zip | 77030-1933
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Country | US
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Telephone | 832-834-3222
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Fax | 832-834-4222
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Provider Business Mailing Address
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Address Line | 2424 W HOLCOMBE BLVD SUITE 101
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City | HOUSTON
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State | TX
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Zip | 77030-1934
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Country | US
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Telephone | 832-834-3222
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Fax | 832-834-4222
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Authorized Official
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Title or Position | OWNER, PHCY MGR, PIC
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Name | MOHAMED KASEB
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Credential | RPH
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Telephone | 832-834-3218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 29287
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License Number State | TX
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