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General NPI Number Information
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NPI Number | 1679963623
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Entity Type | Organization
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Legal Business Name | SANTA MARIA PHARMACY, LLC
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 6108 GULFTON ST
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City | HOUSTON
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State | TX
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Zip | 77081-2304
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Country | US
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Telephone | 713-592-5300
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Fax | 713-592-5302
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Provider Business Mailing Address
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Address Line | 6108 GULFTON ST
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City | HOUSTON
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State | TX
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Zip | 77081-2304
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Country | US
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Telephone | 713-592-5300
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Fax | 713-592-5302
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Authorized Official
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Title or Position | OWNER
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Name | TSIGIE GIRGIRO
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Credential | PHARM.D
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Telephone | 832-687-4132
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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 | 29740
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License Number State | TX
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