Provider Demographics
NPI:1326680034
Name:COLDSPRING BROTHERS, LLC
Entity Type:Organization
Organization Name:COLDSPRING BROTHERS, LLC
Other - Org Name:GREENLAND PHARMACY 5
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULO
Authorized Official - Middle Name:
Authorized Official - Last Name:BARREDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-478-5566
Mailing Address - Street 1:11780 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3514
Mailing Address - Country:US
Mailing Address - Phone:832-478-5566
Mailing Address - Fax:832-304-6583
Practice Address - Street 1:11780 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3514
Practice Address - Country:US
Practice Address - Phone:832-478-5566
Practice Address - Fax:832-304-6583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150164Medicaid