Provider Demographics
NPI:1497137426
Name:MI FARMACIA LLC
Entity Type:Organization
Organization Name:MI FARMACIA LLC
Other - Org Name:MI FARMACIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-614-1693
Mailing Address - Street 1:3317 ORLANDO ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77093-4854
Mailing Address - Country:US
Mailing Address - Phone:832-582-5770
Mailing Address - Fax:713-497-5139
Practice Address - Street 1:3317 ORLANDO ST STE 3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-4854
Practice Address - Country:US
Practice Address - Phone:832-582-5770
Practice Address - Fax:713-497-5139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1324453336C0003X
TX199713336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy