Organization
HOUSTON SOUTHSIDE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SEALS (OWNER)
(713) 839-9400
Entity
Organization
Contact information
Practice address
2626 S LOOP W, STE 404, HOUSTON, TX 77054-2654
(713) 839-9400
(713) 839-9401
Mailing address
2626 S LOOP W, STE 404, HOUSTON, TX 77054-2654
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25215
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4543155
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
11/19/2007
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