Provider Demographics
NPI:1487654869
Name:JOAD INC
Entity Type:Organization
Organization Name:JOAD INC
Other - Org Name:BUFFALO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-664-3426
Mailing Address - Street 1:3118 BISSONNET ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4021
Mailing Address - Country:US
Mailing Address - Phone:713-664-3426
Mailing Address - Fax:713-664-2342
Practice Address - Street 1:3118 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4021
Practice Address - Country:US
Practice Address - Phone:713-664-3426
Practice Address - Fax:713-664-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145190Medicaid