Provider Demographics
NPI:1316534126
Name:P J WORSHAM MANAGEMENT LLC
Entity Type:Organization
Organization Name:P J WORSHAM MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS-WORSHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-582-5252
Mailing Address - Street 1:8103 CREEKBEND DR STE G
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-1556
Mailing Address - Country:US
Mailing Address - Phone:832-582-5252
Mailing Address - Fax:832-582-5847
Practice Address - Street 1:8103 CREEKBEND DR STE G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-1556
Practice Address - Country:US
Practice Address - Phone:832-582-5252
Practice Address - Fax:832-582-5847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy