Medicine Shoppe #1716
10902 Scarsdale Blvd
Houston, TX, 77089
Tel.: (281) 484-8687
Fax.: (281) 481-1321
Request a refill for your medication(s)
Please note that this form allows you to submit up to 5 prescriptions for refill. If you would like to submit more than 5 prescriptions for refill, please complete additional submission forms.


Rx Number(s)

Numbers only
NO letters or dashes