Provider Demographics
NPI:1265596068
Name:FORT BEND FAMILY HEALTH CENTER, INC. PHARMACY
Entity type:Organization
Organization Name:FORT BEND FAMILY HEALTH CENTER, INC. PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-342-4530
Mailing Address - Street 1:400 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4406
Mailing Address - Country:US
Mailing Address - Phone:281-633-3188
Mailing Address - Fax:281-341-2927
Practice Address - Street 1:400 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4406
Practice Address - Country:US
Practice Address - Phone:281-341-2918
Practice Address - Fax:281-341-2927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132383336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy