Organization
WELLCARE OF HOUSTON GROUP, LLC
Active
Other names
WellCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN T PHAN RPH (MEMBER MANAGED)
(408) 661-3881
Entity
Organization
Contact information
Practice address
14343 TORREY CHASE BLVD STE I, HOUSTON, TX 77014-1630
(408) 661-3881
Mailing address
17515 SPRING CYPRESS RD # 256, CYPRESS, TX 77429-2688
(408) 661-3881
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
02/06/2022
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