Organization
MISSOURI CITY PHARMACY LLC
Active
Other names
Missouri City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKALAI LIUBENZY (OFFICER)
(619) 300-0662
Entity
Organization
Contact information
Practice address
1531 HIGHWAY 90 A, SUITE - 200, MISSOURI CITY, TX 77489-1226
(281) 393-4040
(281) 393-4041
Mailing address
1531 HWY 90A, SUITE 200, MISSOURI CITY, TX 77489-1226
(281) 393-4040
(281) 393-4041
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
31971
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177136
PK
—
Enumeration date
04/19/2018
Last updated
10/10/2019
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