Provider Demographics
NPI:1457620775
Name:PQ PHARMACY SERVICES
Entity type:Organization
Organization Name:PQ PHARMACY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:281-579-1310
Mailing Address - Street 1:2430 FRY RD # 104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5831
Mailing Address - Country:US
Mailing Address - Phone:281-579-1310
Mailing Address - Fax:281-579-3385
Practice Address - Street 1:2430 FRY RD # 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5831
Practice Address - Country:US
Practice Address - Phone:281-579-1310
Practice Address - Fax:281-579-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6717800001Medicare NSC