East Freeway Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27544 Issued in TX

Legal business name

EAST FREEWAY PHARMACY LLC

Practice address

12322 East Fwy Ste B1
Houston, TX 77015-5538

Phone

(713) 637-7697

Fax

(713) 637-7698

NPI assigned

Jul 11, 2011

Organization subpart

No

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

Authorized official

Name

Preston Fontenot

Title

Owner

Phone

(713) 637-7697

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Freeway Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1831487982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12322 EAST FWY STE B1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770155538",
            "telephone_number": "713-637-7697",
            "fax_number": "713-637-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12322 EAST FWY STE B1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770155538",
            "telephone_number": "713-637-7697",
            "fax_number": "713-637-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST FREEWAY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-11",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "FONTENOT",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-637-7697"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5903857",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Freeway Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Feb 5, 2013; 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.