Organization
PDPG LLC
Active
Other names
Willowbrook Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETHRA ORION (OWNER/MANAGER)
(281) 894-3103
Entity
Organization
Contact information
Practice address
18720 STATE HIGHWAY 249 STE A, HOUSTON, TX 77070-4297
(281) 894-3103
(281) 894-3102
Mailing address
18720 STATE HIGHWAY 249 STE A, HOUSTON, TX 77070-4297
(281) 894-3103
(281) 894-3102
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
27265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5901980
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/29/2010
Last updated
12/22/2010
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