Organization
LIFECARE REUSS PHARMACY LLC
Active
Other names
Reuss Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAYA KALIDINDI (MANAGING MEMBER)
(505) 268-2030
Entity
Organization
Contact information
Practice address
515 N ESPLANADE ST, CUERO, TX 77954-3603
(361) 275-3411
(361) 275-7383
Mailing address
7267 NOTRE DAME DR, IRVING, TX 75063-3523
(361) 275-3411
(361) 275-7383
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148469
—
TX
01
—
30017
PHARMACY LICENSE
TX
Enumeration date
04/01/2015
Last updated
04/15/2020
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