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General NPI Number Information
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NPI Number | 1629653027
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Entity Type | Organization
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Legal Business Name | MD SPECIALTY PHARMACY
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 1300 BAY AREA BLVD STE B230
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City | HOUSTON
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State | TX
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Zip | 77058-2505
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Country | US
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Telephone | 346-230-7984
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Fax | 281-747-1554
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Provider Business Mailing Address
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Address Line | 2504 BOULDER CREEK CT
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City | PEARLAND
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State | TX
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Zip | 77584-9736
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Country | US
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Telephone | 281-528-3271
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARRYL BOWERS
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Credential | RPH
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Telephone | 281-528-3271
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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 | 3336M0002X
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Taxonomy Name | Mail Order 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 |
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License Number State |
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