Provider Demographics
NPI:1275583015
Name:LP. INC.
Entity Type:Organization
Organization Name:LP. INC.
Other - Org Name:ASCENSIA NUTRITIONAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-665-4400
Mailing Address - Street 1:3003 SOUTH LOOP WEST SUITE 450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054
Mailing Address - Country:US
Mailing Address - Phone:713-665-4400
Mailing Address - Fax:713-665-0309
Practice Address - Street 1:3003 SOUTH LOOP W SUITE 450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1315
Practice Address - Country:US
Practice Address - Phone:713-665-4400
Practice Address - Fax:713-665-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145470Medicaid
TX5718260001Medicare NSC