Organization
THEIA PHARMACY
Active
Organization
THEIA PHARMACY
Active
Other names
Theia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE DURUEWURU (PHARMACIST)
(713) 504-4511
Entity
Organization
Contact information
Practice address
12450 EAST FWY STE 110, HOUSTON, TX 77015-5527
(713) 504-4511
(832) 491-0728
Mailing address
1625 MAIN ST APT 1815, HOUSTON, TX 77002-7546
(713) 504-4511
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31678
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177128
PK
—
Enumeration date
04/27/2018
Last updated
04/27/2018
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