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General NPI Number Information
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NPI Number | 1679863575
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Entity Type | Organization
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Legal Business Name | BURKE FAMILY PHARMACY INC
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 722 FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77504-2804
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Country | US
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Telephone | 832-243-6262
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Fax | 832-243-6692
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Provider Business Mailing Address
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Address Line | 722 FAIRMONT PKWY
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City | PASADENA
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State | TX
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Zip | 77504-2804
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Country | US
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Telephone | 832-243-6262
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Fax | 832-243-6692
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Authorized Official
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Title or Position | OFFICER
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Name | TROY CAMERON
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Credential |
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Telephone | 409-498-0065
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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 | 27402
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License Number State | TX
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