Organization
MANTRA INVESTMENTS INC
Active
Other names
Pecan Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KURIAN AND LIZY BOSE (PRESIDENT/MANAGER)
(713) 861-4300
Entity
Organization
Contact information
Practice address
906 WAYSIDE DR, HOUSTON, TX 77011-2518
(713) 861-4300
(713) 861-4302
Mailing address
6315 COOL WATER DR, SUGAR LAND, TX 77479-5530
(281) 565-5921
(713) 861-4302
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146872
—
TX
01
—
2141437
PK
—
Enumeration date
08/05/2013
Last updated
01/13/2017
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