Provider Demographics
NPI:1528352010
Name:ROSEWOOD FAMILY PHARMACY PLLC
Entity type:Organization
Organization Name:ROSEWOOD FAMILY PHARMACY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:832-604-6038
Mailing Address - Street 1:1010 S MAGNOLIA BLVD STE D
Mailing Address - Street 2:STE 110
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-8550
Mailing Address - Country:US
Mailing Address - Phone:888-730-1069
Mailing Address - Fax:832-604-6038
Practice Address - Street 1:1010 S MAGNOLIA BLVD STE D
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-8550
Practice Address - Country:US
Practice Address - Phone:888-730-1069
Practice Address - Fax:832-604-6038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27505333600000X, 3336C0004X
NY0342903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132425OtherPK