Organization
A 1 PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARINA GUZMAN (MANAGING OFFICER)
(936) 224-5387
Entity
Organization
Contact information
Practice address
10161 TX 242, SUITE 130, CONROE, TX 77385
(936) 224-5387
Mailing address
10161 STATE HWY 242, SUITE 130, CONROE, TX 77385-4374
(936) 209-3553
(936) 242-1824
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33002
STATE BOARD OF PHARMCY
TX
Enumeration date
10/05/2022
Last updated
08/06/2024
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