Organization
RAYVAL, LLC
Active
Other names
Lakepointe Pharmacy, Lakepointe Pharmacy #3
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAM PHUONG VU (DIRECTOR/OWNER)
(469) 733-1033
Entity
Organization
Contact information
Practice address
2715 OSLER DR, GRAND PRAIRIE, TX 75051-1051
(469) 733-1033
(469) 733-1034
Mailing address
2715 OSLER DR STE A, GRAND PRAIRIE, TX 75051-1051
(469) 733-1033
(469) 733-1034
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29311
TX
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146520
—
TX
01
—
2133101
PK
—
Enumeration date
12/15/2011
Last updated
04/01/2019
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