Organization
TRACE PHARMACY LLC
Active
Other names
Trace Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CLEARE (OWNER)
(713) 981-6600
Entity
Organization
Contact information
Practice address
8104 SOUTHWEST FWY STE B, HOUSTON, TX 77074-1704
(713) 981-6600
(713) 981-6605
Mailing address
8104 SW FWY, SUITE B, HOUSTON, TX 77074-1703
(713) 981-6600
(713) 981-6605
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5900368
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/25/2010
Last updated
07/08/2010
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