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General NPI Number Information
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NPI Number | 1710480983
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Entity Type | Organization
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Legal Business Name | LLJ PHARMACY
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 13420 TOMBALL PKWY STE K
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City | HOUSTON
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State | TX
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Zip | 77086
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Country | US
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Telephone | 281-809-8305
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Fax |
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Provider Business Mailing Address
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Address Line | 13420 TOMBALL PKWY STE K
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City | HOUSTON
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State | TX
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Zip | 77086-3167
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Country | US
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Telephone | 281-809-8305
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Fax |
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Authorized Official
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Title or Position | PIC/OWNER
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Name | TU CAM NGUYEN
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Credential |
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Telephone | 281-809-8305
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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 | 31869
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License Number State | TX
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