Organization
PARKSIDE OASIS INC
Active
Other names
GENPHARM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS ODIASE BS, RPH (PHARMACIST, OWNER)
(972) 572-9006
Entity
Organization
Contact information
Practice address
3920 W WHEATLAND RD, STE 100, DALLAS, TX 75237-3401
(972) 572-9006
(972) 572-9016
Mailing address
3920 W WHEATLAND RD, STE 100, DALLAS, TX 75237-3401
(972) 572-9006
(972) 572-9016
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29643
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145449
—
TX
01
—
2095878
PK
—
Enumeration date
12/29/2006
Last updated
04/18/2017
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