Organization
MANOR PHARMACY
Active
Other names
MANOR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DAVIS (MANAGER)
(713) 476-9606
Entity
Organization
Contact information
Practice address
2056 ANTOINE DR, #120, HOUSTON, TX 77055-1833
(713) 476-9606
Mailing address
2056 ANTOINE DR, #120, HOUSTON, TX 77055-1833
(713) 476-9606
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27419
TX
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5903679
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/03/2011
Last updated
08/03/2011
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