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General NPI Number Information
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NPI Number | 1649304189
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Entity Type | Organization
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Legal Business Name | MD PHARMACY
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 11540 EAGLE DR STE A
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City | BAYTOWN
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State | TX
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Zip | 77523-7653
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Country | US
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Telephone | 281-576-0106
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Fax | 281-576-5511
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Provider Business Mailing Address
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Address Line | 11540 EAGLE DR STE A
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City | BAYTOWN
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State | TX
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Zip | 77523-7653
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Country | US
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Telephone | 281-576-0106
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Fax | 281-576-5511
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Authorized Official
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Title or Position | ONWER
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Name | JOHN DYER
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Credential |
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Telephone | 713-829-4611
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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 | 25434
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License Number State | TX
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