Organization
PRASANNA LLC
Active
Other names
Trinity Specialty Pharmacy # 2
Organization subpart
No
Provider details
NPI number
Authorized official
MANOHAR MIRYALA RPH (OFFICER)
(281) 806-7680
Entity
Organization
Contact information
Practice address
19002 PARK ROW STE 101, HOUSTON, TX 77084
(281) 806-7680
(281) 806-7681
Mailing address
1342 FAIR AVE, SAN ANTONIO, TX 78223-1438
(210) 534-5457
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150288
—
TX
Enumeration date
08/09/2020
Last updated
06/05/2023
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