Organization
AVALON RX INC
Active
Other names
Avalon Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VALIMOHAMMED PANARA (OWNER)
(832) 500-3575
Entity
Organization
Contact information
Practice address
12811 BEAMER RD STE 2A, HOUSTON, TX 77089-6140
(832) 500-3575
Mailing address
12811 BEAMER RD STE 2A, HOUSTON, TX 77089-6140
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34091
STATE LICENSE
TX
Enumeration date
04/18/2022
Last updated
05/18/2022
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