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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