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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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