Organization
SAI CARE INC
Active
Other names
Mathis Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVASA RAJU DATLA PHD (OWNER)
(678) 548-3410
Entity
Organization
Contact information
Practice address
217 SOUTH HIGHWAY 359, MATHIS, TX 78368-2703
(678) 548-3410
Mailing address
217 SOUTH HIGHWAY 359, MATHIS, TX 78368-2703
(678) 548-3410
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
30211
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30211
BOARD OF PHARMACY
TX
Enumeration date
09/28/2015
Last updated
09/28/2015
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