Organization
SOUTHERN STAR PHARMACY 002
Active
Other names
AD Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SYEDA SAIMA AHMED RPH (DIRECTOR OF PHARMACY)
(972) 677-7891
Entity
Organization
Contact information
Practice address
2698 N GALLOWAY AVE STE 108, MESQUITE, TX 75150-6390
(469) 646-6057
(877) 743-4398
Mailing address
2698 N GALLOWAY AVE STE 108, MESQUITE, TX 75150-6390
(469) 646-6057
(877) 743-4398
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33256
TX BOP
TX
01
—
5931503
NCPDP
—
Enumeration date
06/02/2020
Last updated
03/17/2026
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