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Organization
YOUR NEW WAVERLY PHARMACY LLC
Active
Organization
YOUR NEW WAVERLY PHARMACY LLC
Active
Other names
Your New Waverly Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA WEBB (AUTHORIZED OFFICIAL)
(936) 344-2424
Entity
Organization
Contact information
Practice address
9320C STATE HIGHWAY 75 S, NEW WAVERLY, TX 77358-4224
(936) 344-2424
(936) 344-2428
Mailing address
9320 STATE HIGHWAY 75 S STE C, NEW WAVERLY, TX 77358-4251
(936) 344-2424
(936) 344-2428
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28286
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5907273
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/19/2012
Last updated
07/30/2026
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