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Organization
WAYSIDE PHARMACY INC
Active
Organization
WAYSIDE PHARMACY INC
Active
Other names
CAUDILLOS
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL CAUDILLO (MGR)
(713) 928-5410
Entity
Organization
Contact information
Practice address
7109 B LAWNDALE AND 75TH, HOUSTON, TX 77023-4244
(713) 928-5410
Mailing address
7109 B LAWNDALE AND 75TH, HOUSTON, TX 77023-4244
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
11705
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142654
—
TX
01
—
4586206
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/18/2006
Last updated
09/11/2025
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