Provider Demographics
NPI:1770794497
Name:PYLANT VILLAGE PHARMACY, INC.
Entity type:Organization
Organization Name:PYLANT VILLAGE PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:PYLANT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-464-5069
Mailing Address - Street 1:975 CORBINDALE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2818
Mailing Address - Country:US
Mailing Address - Phone:713-464-5069
Mailing Address - Fax:713-464-5099
Practice Address - Street 1:975 CORBINDALE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2818
Practice Address - Country:US
Practice Address - Phone:713-464-5069
Practice Address - Fax:713-464-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty