MEDICARE: FRAZIER PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1326645276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRAZIER PHARMACY LLC

Provider Business Mailing Address
First Line	:	932 W DALLAS ST STE E
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-2260
Country	:	US
Telephone Number	:	281-377-0685
Fax Number	:

Provider Business Practice Location Address
First Line	:	932 W DALLAS ST STE E
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-2260
Country	:	US
Telephone Number	:	281-377-0685
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. PAOLA TAMEZ
Credential	:
Telephone Number	:	281-377-0685

Provider Enumeration Date	:	10/05/2020
Last Update Date	:	06/08/2021

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Directions to “FRAZIER PHARMACY LLC ” Practice Location

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