PGM Pharmacy, LLC.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PGM PHARMACY, LLC.

Practice address

7648 Canal St Ste a
Houston, TX 77012-1144

Phone

(713) 924-6067

Fax

(281) 501-0365

NPI assigned

Sep 26, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peta Gay Mattis

Title

Managing Member

Phone

(713) 443-6690

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PGM Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marcus Damon Powell, RPH

  • Pharmacist
  • Houston, TX
  • NPI 1043535149
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1740069095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7648 CANAL ST STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770121144",
            "telephone_number": "713-924-6067",
            "fax_number": "281-501-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7648 CANAL ST STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770121144",
            "telephone_number": "713-924-6067",
            "fax_number": "281-501-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGM PHARMACY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "MATTIS",
        "authorized_official_first_name": "PETA GAY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "713-443-6690"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150868",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PGM Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PGM Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.