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General NPI Number Information
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NPI Number | 1538381801
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Entity Type | Organization
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Legal Business Name | PARK PLACE PHARMACY
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8000 PARK PLACE BLVD
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City | HOUSTON
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State | TX
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Zip | 77087-4644
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Country | US
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Telephone | 713-643-1930
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Fax | 713-649-4212
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Provider Business Mailing Address
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Address Line | 8000 PARK PLACE BLVD
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City | HOUSTON
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State | TX
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Zip | 77087-4644
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Country | US
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Telephone | 713-643-1930
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Fax | 713-649-4212
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM HOWARD DAHLQUIST
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Credential |
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Telephone | 713-643-1930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13975
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License Number State | TX
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