Provider Demographics
NPI:1376904920
Name:HOUSTON COMPOUNDING PHARMACY INC
Entity Type:Organization
Organization Name:HOUSTON COMPOUNDING PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-548-1457
Mailing Address - Street 1:14002 TOMBALL PKWY
Mailing Address - Street 2:#A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086
Mailing Address - Country:US
Mailing Address - Phone:714-548-1457
Mailing Address - Fax:
Practice Address - Street 1:14002 TOMBALL PKWY
Practice Address - Street 2:#A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086
Practice Address - Country:US
Practice Address - Phone:714-548-1457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy