Provider Demographics
NPI:1578603429
Name:C & G PHARMACY
Entity Type:Organization
Organization Name:C & G PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:281-442-4201
Mailing Address - Street 1:11618 ALDINE WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77093-2303
Mailing Address - Country:US
Mailing Address - Phone:281-442-4201
Mailing Address - Fax:281-442-1432
Practice Address - Street 1:11618 ALDINE WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-2303
Practice Address - Country:US
Practice Address - Phone:281-442-4201
Practice Address - Fax:281-442-1432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142571Medicaid