Organization
BRAZO PHARMACY LLC
Active
Other names
ELEVATE RX
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY J STUART (OFFICE MANAGER)
(281) 651-5246
Entity
Organization
Contact information
Practice address
1100 FM 1092 RD STE D, MISSOURI CITY, TX 77459-1588
(281) 651-5246
Mailing address
1100 FM 1092 RD STE D, MISSOURI CITY, TX 77459-1588
(281) 651-5246
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149897
—
TX
01
—
31919
STATE LICENSE
TX
Enumeration date
11/14/2017
Last updated
04/11/2023
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