# WELLCARE OF HOUSTON GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WellCare Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275108227
- **Authorized official:** MR. BRYAN T PHAN RPH (MEMBER MANAGED)
- **Authorized official phone:** (408) 661-3881

## Contact information

- **Practice address:** 14343 TORREY CHASE BLVD STE I, HOUSTON, TX 77014-1630
- **Practice address phone:** (408) 661-3881
- **Mailing address:** 17515 SPRING CYPRESS RD \# 256, CYPRESS, TX 77429-2688
- **Mailing address phone:** (408) 661-3881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/21/2021
- **Last updated:** 02/06/2022