Provider Demographics
NPI:1043351331
Name:E & E PHARMACY
Entity Type:Organization
Organization Name:E & E PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:ENOW
Authorized Official - Last Name:ETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-847-8989
Mailing Address - Street 1:6969 GULF FREEWAY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087
Mailing Address - Country:US
Mailing Address - Phone:713-847-8989
Mailing Address - Fax:713-847-8900
Practice Address - Street 1:6969 GULF FREEWAY
Practice Address - Street 2:SUITE 340
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087
Practice Address - Country:US
Practice Address - Phone:713-847-8989
Practice Address - Fax:713-847-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22451333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144727Medicaid
4504444OtherNABP