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General NPI Number Information
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NPI Number | 1861636243
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Entity Type | Organization
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Legal Business Name | I-10 ATRIUM PHARMACY INC
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 11821 EAST FWY STE 300
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City | HOUSTON
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State | TX
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Zip | 77029-1975
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Country | US
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Telephone | 713-453-8000
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Fax | 713-453-8001
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Provider Business Mailing Address
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Address Line | 8014 TOMAHAWK TRL
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City | HOUSTON
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State | TX
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Zip | 77050-5012
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Country | US
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Telephone | 713-382-8049
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Fax | 281-454-7703
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Authorized Official
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Title or Position | OWNER
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Name | EDITH BAUTISTA
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Credential |
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Telephone | 713-382-8049
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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 | 26304
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License Number State | TX
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