Organization
SOUTH TEXAS PHARMACY GROUP LLC
Active
Organization
SOUTH TEXAS PHARMACY GROUP LLC
Active
Other names
Lakeside Pharmacy South
Organization subpart
No
Provider details
NPI number
Authorized official
TOM CONTRERAS (OWNER/MGR/PHCY TECH)
(956) 725-6337
Entity
Organization
Contact information
Practice address
4151 JAIME ZAPATA MEMORIAL HWY STE 208, LAREDO, TX 78043-4782
(956) 724-2090
(956) 724-2170
Mailing address
4151 BOB BULLOCK LOOP STE 208, LAREDO, TX 78043-4782
(956) 724-2090
(956) 724-2170
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146700
—
TX
01
—
2136707
PK
—
Enumeration date
05/30/2012
Last updated
10/29/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up