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General NPI Number Information
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NPI Number | 1932896362
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Entity Type | Organization
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Legal Business Name | SAMLENAPETER LLC.
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 3251 INTERSTATE 45 N STE 190
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City | CONROE
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State | TX
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Zip | 77304-2185
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Country | US
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Telephone | 310-346-9780
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Fax | 844-333-0369
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Provider Business Mailing Address
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Address Line | 3251 INTERSTATE 45 N STE 190
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City | CONROE
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State | TX
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Zip | 77304-2185
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Country | US
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Telephone | 936-693-2506
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Fax | 844-333-3069
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Authorized Official
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Title or Position | OWNER/PIC
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Name | DR. AGNES H LEE
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Credential | PHARMD
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Telephone | 936-693-2506
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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 |
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License Number State |
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Taxonomy #2
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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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