Organization
SOUTHBELT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND M MEDRANO RPH (PRESIDENT)
(713) 610-9145
Entity
Organization
Contact information
Practice address
11914 ASTORIA BLVD, SUITE 190, HOUSTON, TX 77089-6064
(713) 610-9145
(713) 610-9140
Mailing address
11914 ASTORIA BLVD, SUITE 190, HOUSTON, TX 77089-6064
(713) 610-9145
(713) 610-9140
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
11860
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0913808
—
TX
Enumeration date
09/07/2005
Last updated
08/22/2020
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