Provider Demographics
NPI:1326503137
Name:CULLEN CARE PHARMACY INC
Entity Type:Organization
Organization Name:CULLEN CARE PHARMACY INC
Other - Org Name:PETS & PEOPLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-741-5825
Mailing Address - Street 1:9215 BROADWAY ST STE 113
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8987
Mailing Address - Country:US
Mailing Address - Phone:281-741-5825
Mailing Address - Fax:281-741-2532
Practice Address - Street 1:9215 BROADWAY ST STE 113
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8987
Practice Address - Country:US
Practice Address - Phone:281-741-5825
Practice Address - Fax:281-741-2532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CULLEN CARE PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-05
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150073Medicaid