Provider Demographics
NPI:1093378366
Name:DELIVERIT PHARMACY CLEAR LAKE INC.
Entity Type:Organization
Organization Name:DELIVERIT PHARMACY CLEAR LAKE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABUGHAZALEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-562-6775
Mailing Address - Street 1:12144 DAIRY ASHFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N KOBAYASHI STE 113
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4840
Practice Address - Country:US
Practice Address - Phone:281-724-4828
Practice Address - Fax:281-724-4826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32559OtherSTATE LICENCE