Organization
FUERTES INC
Active
Other names
MY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EFREN FUENTES (OWNER)
(281) 827-3757
Entity
Organization
Contact information
Practice address
2510 BROAD ST, STE 100, HOUSTON, TX 77087-1445
(713) 641-1383
(713) 641-1034
Mailing address
2510 BROAD ST, STE 100, HOUSTON, TX 77087-1445
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4548636
OTHER ID NUMBER
—
Enumeration date
06/19/2008
Last updated
06/19/2008
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