Provider Demographics
NPI:1629452289
Name:SIENNA COMPOUNDING PHARMACY
Entity type:Organization
Organization Name:SIENNA COMPOUNDING PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LOREN
Authorized Official - Last Name:MARKEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-915-5055
Mailing Address - Street 1:9029 HIGHWAY 6
Mailing Address - Street 2:SUITE 190
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4874
Mailing Address - Country:US
Mailing Address - Phone:281-915-5055
Mailing Address - Fax:281-710-4991
Practice Address - Street 1:9029 HIGHWAY 6
Practice Address - Street 2:SUITE 190
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4874
Practice Address - Country:US
Practice Address - Phone:281-915-5055
Practice Address - Fax:281-710-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300753336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX30075OtherSTATE BOARD LICENSE NUMBER