Organization
1960 FAMILY PRACTICE PA
Active
Other names
Express Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA SMITH (PIC)
(281) 453-7205
Entity
Organization
Contact information
Practice address
837 CYPRESS CREEK PKWY STE 105A, HOUSTON, TX 77090-3422
(281) 453-7205
(281) 453-7242
Mailing address
20320 NORTHWEST FWY STE 900, JERSEY VILLAGE, TX 77065-5620
(281) 453-7918
(281) 453-7242
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
27730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146561
—
TX
01
—
2132793
PK
—
Enumeration date
11/08/2011
Last updated
07/28/2015
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