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General NPI Number Information
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NPI Number | 1689810517
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Entity Type | Organization
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Legal Business Name | STAR REX PHARMACY LLC
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 11110 EAST FWY 100B
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City | HOUSTON
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State | TX
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Zip | 77029-1914
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Country | US
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Telephone | 832-767-0816
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Fax | 832-767-0819
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Provider Business Mailing Address
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Address Line | 9701 N SAM HOUSTON PKWY E SUITE 110
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City | HUMBLE
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State | TX
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Zip | 77396-4636
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Country | US
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Telephone | 281-973-8042
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Fax | 281-973-8525
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | BRENTLEY GENTRY
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Credential | B.S.
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Telephone | 281-973-8042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26919
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License Number State | TX
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