Provider Demographics
NPI:1639316417
Name:WINSTON P EPPERSON
Entity Type:Organization
Organization Name:WINSTON P EPPERSON
Other - Org Name:PHARMACY AT CULLEN COMMONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-731-7988
Mailing Address - Street 1:12805 CULLEN BLVD
Mailing Address - Street 2:STE. C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-3759
Mailing Address - Country:US
Mailing Address - Phone:713-731-7988
Mailing Address - Fax:713-731-7854
Practice Address - Street 1:12805 CULLEN BLVD
Practice Address - Street 2:STE. C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-3759
Practice Address - Country:US
Practice Address - Phone:713-731-7988
Practice Address - Fax:713-731-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27736333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4550895OtherNCPDP PROVIDER IDENTIFICATION NUMBER