Organization
HOUSTON ST PHARMACY
Active
Organization
HOUSTON ST PHARMACY
Active
Other names
HOUSTON STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LEA ANN BARRON RN, MSN, FNP (GM)
(903) 526-8030
Entity
Organization
Contact information
Practice address
210 W HOUSTON ST, TYLER, TX 75702-8136
(903) 526-8030
(903) 526-8031
Mailing address
210 W HOUSTON ST, TYLER, TX 75702-8136
(903) 526-8030
(903) 526-8031
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
25313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145743
—
TX
01
—
4543268
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/21/2006
Last updated
04/15/2009
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