Forest Lake Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

11495 Issued in TX

Legal business name

FOREST LAKE PHARMACY

Practice address

9129 Mesa Dr
Houston, TX 77028-1606

Phone

(713) 635-1441

Fax

(713) 635-6810

NPI assigned

Jan 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Francis Chan, R.PH.

Title

Chief Pharmacist

Phone

(713) 635-1441

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1508846056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9129 MESA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770281606",
            "telephone_number": "713-635-1441",
            "fax_number": "713-635-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9129 MESA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770281606",
            "telephone_number": "713-635-1441",
            "fax_number": "713-635-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST LAKE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_title_or_position": "CHIEF PHARMACIST",
        "authorized_official_telephone_number": "713-635-1441",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "11495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142918",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Houston, TX
• Providers in Houston, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; 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.