Houston Southside Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25215 Issued in TX

Legal business name

HOUSTON SOUTHSIDE PHARMACY

Practice address

2626 S Loop W
Ste 404
Houston, TX 77054-2654

Phone

(713) 839-9400

Fax

(713) 839-9401

NPI assigned

Nov 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Seals

Title

Owner

Phone

(713) 839-9400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1225100027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 S LOOP W",
            "address_2": "STE 404",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 S LOOP W",
            "address_2": "STE 404",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542654",
            "telephone_number": "713-839-9400",
            "fax_number": "713-839-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON SOUTHSIDE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "SEALS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-839-9400"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4543155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4543155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.