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Organization
NORTHSIDE PHARMACY LLC
Active
Organization
NORTHSIDE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUNTELLE J ROBINSON (OFFICER)
(832) 940-0424
Entity
Organization
Contact information
Practice address
207 WAYSIDE DR, HOUSTON, TX 77011-3625
(832) 940-0424
(832) 940-0415
Mailing address
207 WAYSIDE DR, HOUSTON, TX 77011-3625
(832) 940-0424
(832) 940-0415
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
30070
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149490
—
TX
Enumeration date
09/23/2015
Last updated
08/03/2026
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