Provider Demographics
NPI:1396041802
Name:HDK ENTERPRISES LLC
Entity Type:Organization
Organization Name:HDK ENTERPRISES LLC
Other - Org Name:SOUTHSIDE PHARMACY II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-660-8888
Mailing Address - Street 1:7700 MAIN STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4457
Mailing Address - Country:US
Mailing Address - Phone:713-660-8888
Mailing Address - Fax:713-661-4828
Practice Address - Street 1:1331 W GRAND PARKWAY NORTH
Practice Address - Street 2:SUITE 111
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2711
Practice Address - Country:US
Practice Address - Phone:832-553-1315
Practice Address - Fax:832-553-1316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy