Organization
SOUTHWEST PHARMACY
Active
Other names
SOUTHWEST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NICHELLE STEWART (PHARMACIST)
(713) 453-0444
Entity
Organization
Contact information
Practice address
17115 RED OAK DR STE 105, HOUSTON, TX 77090-2607
(281) 893-8665
(281) 893-8779
Mailing address
17115 RED OAK DR, SUITE 105, HOUSTON, TX 77090-2641
(281) 893-8665
(281) 893-8779
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145462
—
TX
01
—
2090920
PK
—
Enumeration date
10/11/2007
Last updated
12/28/2015
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