Organization
PROVIDENCE RX PHARMACY LLC
Active
Organization
PROVIDENCE RX PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN CALVILLO (MANAGER)
(936) 204-7892
Entity
Organization
Contact information
Practice address
2500 E TC JESTER BLVD STE 243, HOUSTON, TX 77008-1454
(936) 204-7892
Mailing address
1302 WAUGH DR UNIT 379, HOUSTON, TX 77019-3908
(936) 204-7892
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
04/07/2026
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