Provider Demographics
NPI:1477554210
Name:HOLMAN PHARMACY
Entity Type:Organization
Organization Name:HOLMAN PHARMACY
Other - Org Name:HOLMAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VUI
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:713-776-3500
Mailing Address - Street 1:10000 HARWIN DR STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1671
Mailing Address - Country:US
Mailing Address - Phone:713-776-3500
Mailing Address - Fax:713-776-3503
Practice Address - Street 1:10000 HARWIN DR STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1671
Practice Address - Country:US
Practice Address - Phone:713-776-3500
Practice Address - Fax:713-776-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX176063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2095888OtherPK
TX144607Medicaid